若年性(小児)喉頭乳頭腫の治療 (服部浩教授開講10周年記念論文集)

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Seven patients with juvenile laryngeal papillomatosis, treated at the Kobe University Hospital, Japan mainly using a combination therapy of microsurgical removal and cryosurgery from 1974 to 1981 were investigated.The results are as follows.1. Two adults who were diagnosed for the first time in adulthood as having juvenile laryngeal papillomatosis were cured.2. One adult who suffered from papillomatosis in childhood and had a recurrence 17 years later is thought to be under control.3. One young adult who suffered from papillomatosis and was treated by radiation therapy in childhood died of radiation-induced cancer.4. Two children whoes papillomatosis were cured, but one has a vocal cord atresia after the treatment.5. One child who has frequent recurrences is under treatment.From the above results, the following conclusions were drawn.1. There is no absolutely effective therapy for juvenile laryngeal papillomatosis and multidisciplinary treatment is considered to be the best method at present.2. Irradiation for this disease especially for children must be avoided.3. In order to avoid dissemination, silastic tracheostomy tubes should be used and unnecessary suctioning should be avoided during treatment.4. Cryosurgery is superior to surgical resection in that the healing process of the treated area after cryosurgery is better than that after surgical resection. In our case, cryosurgery under local anesthesia was effective in the disseminated papillomatosis in the trachea. But care should be taken not to freeze too much tissue to avoid laryngeal adhesion and tracheal stenosis.5. Attention should be given to recurrent nerve palsy and vocal cord atresia probably due to frequent and excessive surgical removal and cryosurgery.In such cases, tracheostomy should be performed before operation.
耳鼻咽喉科臨床学会の論文

若年性(小児)喉頭乳頭腫の治療 (服部浩教授開講10周年記念論文集)

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