Curative effect of cold micro forceps and CO₂ laser in the treatment of laryngeal amyloidosis

Abstract

Background: Amyloidosis is a benign, slowly progressive disease. However, the treatment of laryngeal amyloidosis (LA) has not been studied systematically.

Objectives: To investigate the treatment results of cold micro forceps or carbon dioxide laser under microlaryngoscope in the treatment of LA.

Methods: A retrospective review was conducted for the cases collected from January 1990 to March 2016 at our department.

Results: One hundred and eighteen patients (44 males and 74 females, with an average age of 51.7 years) with LA were identified. The amyloidosis was not found in organs other than the larynges and tracheas. The patients most commonly presented with hoarseness and dyspnea. All patients underwent surgical removal of the amyloid deposits (via micro forceps or CO₂ laser). Twenty-nine patients developed recurrences requiring further treatments. The mean interval from treatments to recurrences in these patients was 16.5 months. Five patients were treated more than once. No significant difference was found between cold micro forceps and CO₂ laser methods in recurrences.

Conclusions: LA generally behaves as a benign disease. Resection of LA either via cold micro forceps or CO₂ laser under microlaryngoscope is both safe and effective methods. Regular follow-up with laryngoscopy is indicated for early diagnosis of recurrence.

Chinese abstract

背景：淀粉样变病是一种良性、进程缓慢的疾病。然而, 对喉淀粉样变病（LA）的治疗还没有经过系统性研究。

目的：探讨显微喉镜下使用冷微型镊或二氧化碳激光治疗LA的疗效。

方法：对我科1990年1月至2016年3月收治的病例进行回顾性分析。

结果：确诊LA患者118例, 男44例, 女74例, 平均年龄51.7岁。除喉和气管外, 其他器官均未见淀粉样变。最常见的症状是声音嘶哑和呼吸困难。所有患者均接受手术切除淀粉样沉积（通过微型镊子或二氧化碳激光）。29名患者出现复发, 需要进一步治疗。这些患者从治疗到复发的平均间隔为16.5个月。5名患者接受了一次以上的治疗。冷微镊与二氧化碳激光治疗复发率无显著性差异。

结论：LA一般表现为良性疾病。显微喉镜下冷微镊或二氧化碳激光切除LA都是安全有效的方法。定期喉镜随访有助于尽早诊断复发。

Keywords:

• Laryngeal amyloidosis
• hoarseness
• dyspnea
• cold micro forceps
• CO₂ laser
• tracheotomy

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This study was supported by Science and Technology Commission of Shanghai Municipality (CN) [grant number: 14DZ1940702].