良性声带病变的复发：回顾性队列中的危险因素及冷器械与CO2激光手术的探索性比较
Recurrence of Benign Vocal Fold Lesions: Risk Factors and an Exploratory Comparison of Cold-Instrument and CO2 Laser Surgery in a Retrospective Cohort.
文献信息
| PMID | 42796385 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Alexandru Vlase |
| 作者单位 | Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania. |
| 期刊 | Medicina (Kaunas, Lithuania) |
| SCI 分区 | Q1 |
| IF | 3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景与目的： 良性声带病变（BVFLs）是持续性发声困难的常见原因，但复发估计受病变类型、结局定义和随访影响。我们评估了记录病变消退后的复发情况，并探索了临床因素和手术技术。
材料与方法： 我们进行了一项单中心回顾性队列研究，纳入2022年1月至2024年12月间首次记录BVFL诊断的214名成人。临床记录审查至2026年1月。复发定义为初始治疗后喉部评估记录消退后病变再次出现；持续性病变单独分类。
结果： 142名患者（66.4%）有随访记录。135名患者记录初始病变消退，其中23名出现复发（17.0%）；7名患者在初始治疗后评估时存在持续性疾病。单变量分析中，未发现所评估的人口学或临床因素与复发显著相关。在次要探索性手术分析中，冷器械治疗的患者中有7/29复发（24.1%），CO2激光治疗的患者中有3/27复发（11.1%；OR 2.55，95% CI 0.58-11.08；Fisher精确检验p = 0.299）。
结论： 初始病变消退后记录复发发生于17.0%的患者。手术技术比较把握度不足且未校正，不能确立任一技术的优越性。解释复发比例时应考虑随访变异和差异性失访。
英文摘要
Background and Objectives: Benign vocal fold lesions (BVFLs) are common causes of persistent dysphonia, but recurrence estimates are influenced by lesion type, outcome definition, and follow-up. We evaluated recurrence after documented lesion resolution and explored clinical factors and surgical technique. Materials and Methods: We performed a single-center retrospective cohort study of 214 adults with a first documented BVFL diagnosis between January 2022 and December 2024. Clinical records were reviewed through January 2026. Recurrence was defined as lesion reappearance after documented resolution at the initial post-treatment laryngeal assessment; persistent lesions were classified separately. Results: Follow-up was documented in 142 patients (66.4%). Initial lesion resolution was documented in 135 patients, of whom 23 developed recurrence (17.0%); 7 patients had persistent disease at the initial post-treatment assessment. No evaluated demographic or clinical factor was significantly associated with recurrence in univariate analyses. In the secondary exploratory surgical analysis, recurrence occurred in 7/29 patients treated with cold instruments (24.1%) and 3/27 treated with CO2 laser (11.1%; OR 2.55, 95% CI 0.58-11.08; Fisher exact p = 0.299). Conclusions: Documented recurrence after initial lesion resolution occurred in 17.0% of patients. The surgical technique comparison was underpowered and unadjusted and does not establish superiority of either technique. Variable follow-up and differential attrition should be considered when interpreting the recurrence proportion.