声帯瘢痕に対する治療 —病態の評価から再生手術まで—

抄録

Vocal-fold scarring is one of the most intractable diseases that cause hoarseness. Stroboscopy can be used to estimate the severity of vocal-fold scarring. Many animal and human studies have reported on the efficacy of innovative therapies for vocal fold scarring. Voice therapy is one such effective treatment for patients with mild-to-moderate scarring. Regarding surgical intervention for vocal fold scarring, removal of scar tissue with minimally invasive surgery using the microflap technique may be helpful for managing localized fibrosis of the lamina propria. However, regeneration therapy is a better option for managing the vocal fold scar itself. Vocal fold injection of basic fibroblast growth factor is effective for ameliorating vocal fold scarring, particularly mild-to-moderate scarring. In addition, a phase 3 trial of vocal fold injection therapy with hepatocyte growth factor, which may provide significant therapeutic efficacy for severe scarring, is currently underway.