声带血管扩张症21例临床分析

目的探讨声带血管扩张症的诊断和治疗。方法总结分析21例患者的临床资料。所有患者均有不同程度的声音嘶哑，其中女性15例，男性6例；年龄23～68岁，中位年龄44岁；血管扩张位于右侧声带12例，左侧声带9例。单纯声带血管扩张10例；声带血管扩张伴发声带息肉8例，伴发声带小结2例，伴发一侧声带麻痹1例。所有患者随访6个月以上。结果在电视喉镜下显示扩张的小血管从声带前端开始向后延伸至声带中部的6例，表现为扩张的血管在声带中部进一步扩张成类似小的血管瘤者3例，或表现点状、片状或短线状血管扩张12例。8例伴声带息肉的患者摘除声带息肉手术后复查见2例声带表面血管扩张消失，6例血管扩张无变化，声嘶明显改善；其余13例患者进行声带休息治疗，12例复查病变无变化，但声休后主观感觉声音嘶哑症状好转，1例患者未注意声带休息，3个月时因声音嘶哑加重，就诊发现对侧声带黏膜下出血，6个月复查时血管扩张未见变化，但对侧声带黏膜下出血吸收消失。结论声带血管扩张症好发于女性患者，做喉镜检查可明确诊断，治疗以声休为主，反复出血或持续声嘶者可考虑手术。

Varices of the vocal cord: report of 21 cases

Objective To study the diagnosis and treatment of varices of the vocal cord.MethodsThe clinical data of 21 cases with varix of vocal cord were analyzed.All the patients presented hoarseness.There were 15 female and 6 male cases with their ages ranged from 23 to 68 years(median 44 years old).The varix was found on the right vocal cord in 12 cases,on the left vocal cord in 9 cases.Isolated varix existed on the vocal cord in 10 cases,varix with vocal cord polyps or nodules in 10 cases,varix with vocal cord paralysis in 1 case.Results All the patients were diagnosed under the laryngovideoscope.The lesions appeared on the superior surface of the vocal cord.Varices manifested as abnormally dilated capillary running in the anterior to posterior direction in 6 cases,as clusters of capillary in 3 cases,as a dot or small sheet or short line of capillary in 12 cases.The varices were disappeared in 2 of 8 cases with vocal cord varices and polyps after removed the polyps.The varices of others patients had no change after following up for more than 6 months,but one patient happened hemorrhage of the contralateral vocal cord.ConclusionsVarices are most commonly seen in female.Laryngovideoscopy is the key in determining the vocal fold varices.Management of patients with a varix includes medical therapy,speech therapy,and occasionally surgical vaporization.