声帯ポリ-プの成因に関する臨床的並びに病理組織学的研究補遺--殊に超微構造的解析
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概要
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Various reports have been published on the causative factors of polyp of the vocal cords. In the present study, laryngeal polyps were examined by optical and electron microscopy, with special respect on the allergic reactions which are regarded a one of its possible causative factors.For electron microscopic examination, materials were stained with PAM.or Ruthenium Red, which are usually employed to demonstrate mucopolysaccharides.This study was conducted on the 124 patients with laryngeeal polyp who visited our clinic during the five year period from April, 1970 to March, 1975.All of their polyps were removed by laryngo-micro surgeny NLA.The results were as follows.1) Clinical ExaminationThe polyps were most frequently found in the anterior and middle one-third of the vocal cords (about 50 %).It can be said that this is due to the distribution of blood vessels, specifi- city of vascular structure, and the torsional movement of the vocal cords muscules.2) Electron Microscopic Observations Electron microscopic examination revealed the degeneration and dilatation of intercellular space of mucosal epithelium and intracellular edema.In the mucosal matrix, dilatation of micro- vasculature, hemangioma-like degeneration, and perivascular infiltrations of histiocytes or other mononuclear cells were noted.Moreover, marked microfiber and fibrostic substances were observed.In many cases, an increase in the acidic mucopolysaccharides and PAM-stain positive colloidal fiber in the matrix were noted, as well as an increase of the capillary permeability. Although various reports have been published, on the causative factors of the polyp of the vocal cords, it can be said that the disease may be caused by various factors rather than by a single factor.In this study, detailed electron microscopic observation was made on the shaft like structure which is specific for the peripheral blood vessels in the vocal cords and found that immunolo- gical factors are important in the pathogenesis of this disease.The local abnormalities and the specificity of blood vessels of the vocal cords are also important factors.
- 社団法人 日本耳鼻咽喉科学会の論文