110例声带任克水肿病理特征分析  

Pathological analysis for 110 Cases with Reinke's edema of the vocal cord

作　　者：万光伦 赵婉 孙敬武 陈浩[1] 李万举 胡燕明 WAN Guanglun;ZHAO Wan;SUN Jingwu;CHEN Hao;LI Wanju;HU Yanming(Department of Otolaryngology Head and Neck Surgery,The First Affiliated Hospital of USTC,Anhui Provincial Hospital,Hefei,230001,China)

机构地区：[1]中国科学技术大学附属第一医院 安徽省立医院耳鼻咽喉头颈外科,安徽合肥230001

出　　处：《中国中西医结合耳鼻咽喉科杂志》2018年第4期272-274,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：安徽省自然科学青年基金资助(No.1608085QH224)

摘　　要：目的分析声带任克水肿术后的病理特征。方法选择手术治疗的110例声带任克水肿患者的病理资料进行分析,其中男性88例,女性22例,年龄38~79岁,平均53.0岁,中位年龄52岁,单侧病变者1例,双侧病变者109例。吸烟者76例(69%),无吸烟史者34例(31%),所有患者均在全麻支撑喉镜下遵循嗓音外科原则行手术治疗,术中尽量清理黏膜下胶冻样物,切除病变组织,保留适量正常黏膜覆盖声带术后创面,将切除的组织送病理检查。结果中年以后为任克水肿的好发年龄,吸烟是其重要发病原因。喉镜下主要表现为声带鱼腹样改变,有时合并息肉或角化。110例患者病理结果中24例具有鳞状上皮增生,8例轻度不典型增生,1例中度不典型增生,12例合并鳞状上皮角化或角化不全。结论吸烟是引起声带任克水肿重要的致病因素。部分声带任克水肿患者伴有不典型增生或角化等病理改变,其可能为喉癌前病变之一。Objective To investigate the pathological features of the Reinke＇s edema. Methods Pathological data of 110 patients（88 males and 22 females） with vocal cord edema who underwent surgical treatment were analyzed. The patients ranged in age from 38 to 79 years old, with an average age of 53 years old and the median age was 52 years old. One case had unilateral lesion, 109 cases had bilateral lesion. There were 76 smokers（69%） and 34 cases（31%） without smoking history. All patients underwent surgical treatment with a suspension laryngoscope under general anesthesia according to the principles of voice surgery. During the operation,the submucosal jelly samples were removed as much as possible, the diseased tissue was removed, and the normal mucosa was preserved to cover the vocal cords. The resected tissue was sent for pathological examination. Results Middle age or later was the predilection age of Reinke＇s edema, smoking was an important cause. Under laryngoscopy, the main manifestation was vocal cord fish abdomen changes, sometimes combined with polyps or keratosis. Of the 110 patients, 24 cases had squamous epithelial hyperplasia, 8 cases had mild dysplasia, 1 case had moderate dysplasia, and 12 cases had squamous epithelial keratosis or parakeratosis. Conclusion Smoking was an important causative factor of vocal cord edema. Some patients with vocal cord edema with pathological changes such as dysplasia or keratosis may be one of the precancerous lesions of the larynx.

关 键 词：任克水肿 声带 病理 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]