Document Detail


Does subepithelial hemorrhage cause persistence of laryngeal granuloma?
MedLine Citation:
PMID:  18197133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the incidence of black spots after resolution of laryngeal granuloma (LG), to compare the disease duration from the beginning of treatment to resolution between patients with and without black spots, and to assess the histologic findings of LG in resected or biopsied specimens. STUDY DESIGN: Retrospective. METHODS: Forty-six patients with LG on the cartilaginous portion of the vocal fold were included. Their clinical records were reviewed. Histologic specimens were re-examined. RESULTS: Causes of LG were postintubation in 10 patients, unilateral vocal fold immobility in 1, Candida infection in 1, and were not specified in 34 (either hyperfunctional vocal abuse, laryngopharyngeal regurgitation, or both). Of the 10 patients with postintubation LG, 9 resolved; of the 33 patients with LG from other causes, 21 resolved. Of the 28 resolved patients, 12 developed a black spot at the previous lesion site. Of the 18 patients whose LG resolved without surgical intervention, 11 developed a black spot at the previous lesion site, and the remaining 7 patients did not develop any black spots. The treatment period until LG resolution was significantly longer among patients with a black spot than those without a spot (P = .0372). Histologic examination revealed the presence of hemosiderin accumulation accompanied by infiltration of lymphocytes and macrophages in 8 of the 16 patients who had their LGs resected or biopsied. CONCLUSIONS: Accumulation of hemosiderin in the subepithelial layer, together with little blood flow and dense connective tissue in the cartilaginous portion of the vocal fold, are important factors contributing to the persistence of LG.
Authors:
Eiji Yumoto; Tetsuji Sanuki; Satoru Miyamaru; Yoshihiko Kumai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  118     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-01     Completed Date:  2008-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  932-7     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto University, Honjo, Kumamoto, Japan. yu6167@gpo.kumamoto-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biopsy
Candidiasis / microbiology
Epithelium / metabolism,  pathology
Female
Granuloma / etiology*,  pathology*
Hemorrhage / complications*
Hemosiderin / metabolism
Humans
Hyperplasia / metabolism,  pathology
Laryngeal Diseases / etiology*,  microbiology,  pathology*
Lymphocytes / metabolism
Male
Middle Aged
Vocal Cords / metabolism,  microbiology,  pathology*
Chemical
Reg. No./Substance:
9011-92-1/Hemosiderin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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