喉頭
Online ISSN : 2185-4696
Print ISSN : 0915-6127
ISSN-L : 0915-6127
シンポジウム1 「喉頭気管乳頭腫の最前線」
喉頭乳頭腫症における組織学的背景に基づいた手術
栗田 卓梅野 博仁千年 俊一小野 剛治深堀 光緒子末吉 慎太郎
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2021 年 33 巻 02 号 p. 76-81

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Laryngeal papilloma is a benign intraepithelial tumor caused by human papilloma virus (HPV) type 6 or 11. Because of latent HPV infection in the epithelial basal cells, the papilloma frequently recurs. Since the optimal medication strategy has not yet been established, the main treatment is surgical removal. To perform precise papilloma surgery, the histological characteristics of the laryngeal mucosa, as well as laryngeal papilloma, are important to consider. A frequent site of papilloma is the epithelial junction between stratified squamous epithelium and pseudostratified ciliary columnar epithelium, although HPV can infect each type of epithelium. Not only the susceptibility and infection of HPV but also epithelial stratification play an important role in the development of papilloma. The aim of the surgery is complete removal of the papilloma with little scar formation and adhesion of the mucosa, which can cause voice disorder and airway stenosis. To achieve this aim, subepithelial resection along the basal lamina is crucial. Removal of the superficial lamina propria, as in ELS type I cordectomy, should be avoided. To reduce scar formation and adhesion after wide-range tumor resection, performing wound sealing with a polyglycolic acid sheet is useful. This method prevents tissue deficit and delivers a larger mucosal amplitude of the vocal fold mucosa.

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