Localized laryngeal amyloidosis: A systematic review |
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| Affiliation: | 1. Department of Otolaryngology, Geisinger Health System, Danville, PA, USA;2. Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT, USA;3. Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA;4. Department of Internal Medicine, NorthShore University Health System, Evanston, IL, USA;5. Department of Otorhinolaryngology – Head and Neck Surgery, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, NY, USA;6. Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA;7. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ, USA;8. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA;9. Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA;10. Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center – RWJBarnabas Health, Livingston, NJ, USA;11. UCSF Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA |
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| Abstract: | ObjectiveThe larynx is the most common site of localized head and neck amyloidosis. Our study aimed to review the clinical features, treatments, and outcomes associated with localized laryngeal amyloidosis (LA). We also compared these features between two different time periods to evaluate the evolution of LA management.MethodsA literature search using PubMed, CINAHL, Embase, and Cochrane Library identified cases of LA published between 1891 and 2021. Biopsy-proven cases of localized LA were included. Non-English studies, animal studies, and reviews were excluded.Results282 patients (1891–1999: 142 patients, 2000–2021: 140 patients) from 129 studies were included. Results are reported as 1891–2000 vs. 2000–2021: Mean age was 48.5 years (range, 8–90 years) vs. 46.0 years (range, 9–84 years). The most common presenting symptoms were dysphonia (n = 30, 95 % vs. n = 127, 96 %) and difficulty breathing (n = 37, 27 % vs. n = 35, 27 %). A total of 62 (44 %) vs. 46 (33 %) lesions were found in the true vocal folds and 35 (25 %) vs. 59 (42 %) were found in the false vocal folds. 133 (94 %) vs. 137 (98 %) patients underwent surgical interventions to investigate and/or treat LA. Recurrent LA was reported in 27 (19 %) vs. 33 (24 %) patients with a mean time to recurrence of 25.4 months (range, 0.3–132 months) vs. 34.5 months (range, 0.8–144 months). Of cases reporting survival rate, 104 (97 %) vs. 107 (99 %) were alive at source study endpoints.ConclusionLA typically exhibits an indolent course; therefore, early intervention may address longstanding symptoms. Recurrent disease poses a clinical challenge in patients with LA. |
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