耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
臨床
マイクロデブリッダーによる成人型多発性喉頭乳頭腫手術の2例
渡邊 嶺岩崎 朱見杉本 太郎古宇田 寛子喜多村 健
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2010 年 103 巻 12 号 p. 1115-1119

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We report two cases of adult multiple laryngeal papillomatosis, endoscopically excised using a microdebrider. Case 1: A 37-year-old man suffered from a sensation of a lump in the throat. Case 2: A 27-year-old man suffered from hoarseness. Both presented with multiple papillary lesions on the vocal cords and in the supraglottic area.
Using a laryngeal microdebrider under laparoscopy to resect lesions we obtained good vocal quality 12 months postoperatively in case 1 and 8 months after operation in case 2. Case 2 suffered recurrence on the left vocal cord. Both cases were diagnosed postoperatively as squamous papilloma and human papilloma virus (HPV) type-6 and 11 were genotyped in specimens from case 1 and 2, respectively.
Multiple laryngeal papillomatosis is benign, caused by human papilloma virus characterized by recurrent, disseminative respiratory tract growth. Current treatment is surgical, but preserving laryngeal function is an issue. The microdebrider thus effectively resects fine lesions without thermally damaging surroundings. This leaves fewer adverse effects and improves vocal quality more than the heated instruments such as the CO2 laser widely used in Japan.

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