ムヒョンテ院長は耳鼻咽喉科分野の国際学術誌の中で最も権威のある最高位の‘the Laryngoscope’に論文を発表しました。喉頭乳頭腫除去手術以降の再発パターンの発見とこれによる臨床的な治療結果に関する研究論文で、喉頭乳頭腫の完治可能性を知らせる世界初、唯一の論文です。
この論文は、8年4ヶ月間86名の喉頭乳頭腫患者を対象に行われた研究であり、疾病の再発パターンを分析した結果、手術と共に補助的な治療療法を施行した場合、喉頭乳頭腫の完治可能性が高くなるという結果を明らかにしました。
研究論文題名 : Is Recurrent Respiratory Papillomatosis a Manageable or Curable Disease?
論文誌名 : Laryngoscope, 126:1359–1364, 2016
要約 :
Objectives: Recurrent respiratory papillomatosis (RRP) is a relatively rare disease with potentially devastating consequences for the patient. The purpose of this study was to evaluate the patterns of recurrence of RRP after surgery and determine the effectiveness of combined concurrent adjuvant therapy.
Methods: A total of 86 patients were diagnosed with and operated on for RRP. The clinical characteristics of 29 of the 86 patients who had undergone operations at other hospitals and who were followed up for >2 years were evaluated retrospectively. A combined concurrent adjuvant therapy was performed with microlaryngeal surgery, 585-nm pulsed dye laser (PDL) application, and an intralesional cidofovir injection. To evaluate the recurrence pattern, the larynx was divided into 10 subsites, and patients were investigated for the frequency of recurrence at the subsites after the operation.
Results: Twenty-nine subjects required a mean of 3.0 operations to achieve complete remission for 2 years. The most common subsites for recurrence were the anterior commissure, subglottis, and epiglottis according to increasing number of operations. The subsites of recurrence tended to be closely correlated with the laryngeal submucosal glandular density distribution. A complete en-bloc layer excision, including the submucosal glands, using cold instruments decreased the recurrence rate of RRP. Applying PDL minimized scarring and provided significant posttreatment voice-quality improvement.
Conclusions: The results of the recurrent pattern analysis suggest that a combined concurrent adjunctive treatment might be promising as a cure for RRP and restoration of vocal function after treatment.
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