Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (1): 43-49.doi: 10.24920/003861

• 论著 • 上一篇    下一篇

声带竹节病 —— 14例临床病例研究

王轶1,吴婵媛2,*(),王迁2,*()   

  1. 1耳鼻喉科,北京协和医院,中国医学科学院&北京协和医学院,北京 100730,中国;
    2风湿免疫科;北京协和医院,中国医学科学院&北京协和医学院,北京 100730,中国;
  • 收稿日期:2020-12-03 接受日期:2021-01-18 出版日期:2021-03-17 发布日期:2021-03-17
  • 通讯作者: 吴婵媛,王迁 E-mail:wchypumch@hotmail.com;wangqian_pumch@126.com

Bamboo Nodes of Vocal Fold—A Clinical Study of 14 Cases

Yi Wang1,Chanyuan Wu2,*(),Qian Wang2,*()   

  1. 1Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
    2Department of Rheumatology and Clinical Immunology; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
  • Received:2020-12-03 Accepted:2021-01-18 Published:2021-03-17 Online:2021-03-17
  • Contact: Chanyuan Wu,Qian Wang E-mail:wchypumch@hotmail.com;wangqian_pumch@126.com

摘要:

目的声带竹节病系与自身免疫病相关的罕见疾病,文献报道声带竹节病仅见于女性。本研究旨在进一步探讨声带竹节病的临床特点和诊疗经验。

方法 回顾性搜集2011至2020年北京协和医院诊断为声带竹节病的全部患者及相关临床信息、伴随的自身免疫病、用声情况及治疗方法。患者定期门诊随访,行纤维喉镜随诊声带情况及采用嗓音视觉模拟量表自我评估声音恢复情况。

结果 共获得14例诊断为声带竹节病的患者,13例(92.9%)患者双侧声带受累。女性8例(57.1%),男性患者6例(42.9%)。最常见的症状为声音嘶哑(100%,14/14)。用声过度占71.4%(10/14)。13例(92.9%)为自身免疫病患者,给予针对自身免疫病的药物治疗和嗓音休息;1例为胃食道返流患者,接受抗酸治疗和嗓音休息。3例(21.4%)患者声音完全恢复,8例(57.1%)患者声音显著恢复,1例(7.1%)患者轻度恢复,2例(14.3)患者声音无改善。

结论 声带竹节病与自身免疫病和用声过度有关。男女均可受累。自身免疫病的药物治疗和嗓音休息对大多数患者声音恢复有益,可作为本病的首选治疗。

关键词: 声带竹节病, 自身免疫病, 声音嘶哑, 用声过度, 保守治疗

Abstract:

Objective Bamboo node (BN) of vocal folds is a rare disease which is mostly associated with autoimmune diseases and always involves women as reported in literature. The purpose of this study is to investigate the clinical characteristics and the treatments in a series of BN cases.

Methods We retrospectively collected and reviewed clinical information of all patients who presented bamboo nodes by fibreoptic laryngoscopy from 2011 to 2020 in our hospital, including the demographic information, clinical symptoms, associated autoimmune diseases, voice abuse, treatments, and outcomes. Patients were followed up periodically at clinics with fibreoptic laryngoscopy and/or voice recovery evaluation using the self-assessed voice visual analog scale (VAS).

Results Totally 14 patients were diagnosed with BN and were included in the study. BN involved both women (8/14, 57.1%) and men (6/14, 42.9%). Bilateral lesions were found in 13 patients (92.9%). The most common symptom of BN was hoarseness (100%). Ten (71.4%) of 14 patients experienced voice abuse. Thirteen (92.9%) of them were concomitant with autoimmunity disease, and received medication therapy for the underlying autoimmune diseases; one patient received anti-acid treatment for the gastroesophageal reflux disease. Voice rests were performed in all patients. Voice recovered completely in 3 cases (21.4%), improved remarkably in 8 cases (57.1%), improved slightly in 1 case (7.1%), and no improvement in 2 cases (14.3%).

Conclusions BNs are mostly associated with autoimmune disease and vocal abuse. It may occur in both females and males. Conservative treatment for the underlying autoimmune diseases and vocal rest are beneficial to voice recovery in most of the patients, and can be used as the first choice of treatment.

Key words: bamboo nodes, autoimmune disease, hoarseness, voice abuse, conservative treatment

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