Current clinical propensity of laryngeal tuberculosis: review of 60 cases
Current clinical propensity of laryngeal tuberculosis: review of 60 cases
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DOI：
10.1007/s00405-006-0063-5
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发表时间：
2006-09-01
影响因子：
2.6
通讯作者：
Choi, Hong-Shik
中科院分区：
文献类型：
--
作者：
Lim, Jae-Yol;Kim, Kwang-Moon;Choi, Hong-Shik
虽然喉结核并不常见，但随着肺结核发病率的增加，喉结核仍会发生。该病的临床表现和传播机制也发生了变化。本研究旨在探讨喉结核的流行趋势和非典型临床类型患者的临床特征。方法对1994 ~ 2004年我院耳鼻咽喉科收治的60例喉结核患者的临床资料和动态喉镜检查结果进行分析。患者年龄25 ~ 78岁，平均49.7岁。男女比例为1.9：1。主要症状为声嘶（96.6%）。临床上，肉芽肿型喉结核22例，溃疡型喉结核11例，而非典型型喉结核如息肉型喉结核16例，非特异性喉结核11例。27例息肉样或非特异性类型中，单侧病变20例（74%）。病变部位以真声带最多见，其次为假声带、会厌、杓状软骨和后连合。活动性肺结核28例（46.7%），非活动性肺结核20例（33.3%），肺功能正常12例（20%）。原发性喉结核9例（15%）。在非活动性结核或肺部状态正常的患者中，单发病变、息肉样病变和非特异性类型多见。医生应该意识到喉结核的临床模式的变化，这会带来严重的并发症和传播的风险。
Although laryngeal tuberculosis is not frequent, it still occurs with an increasing incidence of pulmonary tuberculosis. Clinical pattern and spread mechanism of this disease have also changed as well. This study was performed to examine the current propensity seen in laryngeal tuberculosis and the clinical characteristics of this disease in patients showing atypical clinical pattern. The medical and videostroboscopic records of 60 patients with laryngeal tuberculosis diagnosed from the year 1994 to 2004 at the department of otorhinolaryngology in Severance Hospital were analyzed. The age of the patients ranged from 25 to 78 years, with their average age being 49.7 years. The ratio between men and women was 1.9:1. The major symptom encountered was hoarseness (96.6%). Clinically, granulomatous (n=22) and ulcerative types (n=11) of laryngeal tuberculosis were still prevalent, however, the incidence of atypical types such as polypoid (n=16) and nonspecific (n=11) were on the rise. Among the 27 cases that showed polypoid or nonspecific types, unilateral lesion was seen in 20 cases (74%). The most frequently affected area by this disease was true vocal cord, followed by false vocal cord, epiglottis, arytenoids and posterior commissure. Active pulmonary tuberculosis was present in 28 (46.7%), inactive pulmonary tuberculosis in 20 (33.3%), normal lung status in 12 cases (20%). Primary laryngeal tuberculosis was present in 9 cases (15%). Single lesion, polypoid and nonspecific type were prevalent in patients with inactive tuberculosis or normal lungs status. Physicians should be aware of the changes in the clinical pattern of laryngeal tuberculosis, which poses serious complications and risk of spreading.