Clinicalanalysis Of Factors Affecting Recurrence Of Vocal Cord Polyps After Surgery

Objective: To analyze and summarize the risk factors of postoperative recurrence of vocal cord polyps,to further improve people’s understanding of the factors of vocal cord polyp recurrence,so as to guide the diagnosis and treatment of patients,the postoperative health education of patients and reduce the recurrence rate of vocal cord polyps.Method: For the 54 patients admitted to our department from September 2016 to September 2018,who had a history of vocal cord polyp surgery and were diagnosed as vocal cord polyp recurrence by postoperative pathological examination or vocal cord neoplasm biopsy.The general situation,clinical symptoms,electronic nasopharyngoscopy and pathological examination results of the patients were retrospectively analyzed.Result: All the 54 patients were inpatients,including 28 males(28/54,51.8%)and 26 females(26/54,48.2%),aged 31-68,with an average age of46.4.Before this hospitalization,28 patients had unreasonable use of voice in their daily life(28/54,51.8%),27 patients had a history of smoking(27/54,50%),25 patients had a history of drinking(25/54,46.3%),and 13 patients had a history of repeated colds(13/54,24.1%).Two patients had symptoms of laryngopharyngeal reflux(2/54,3.7%).Postoperative pathology or vocal cord neoplasm biopsy confirmed vocal cord polyp in 54 patients.Main symptoms: All the 54 patients had hoarseness of varying degrees(54/54,100%).20 patients had dry pharynx,pharynx itching or pharynx pain(20/54,37.0%),and 23 patients had pharyngeal foreign body sensation(23/54,42.6%).12 patients had dysphonia and labored speech(12/54,22.2%).One patient had occasional aphonia(1/54,1.8%).One patient had occasional dyspnea(1/54,1.8%),which was bilateral wide-base polyp.Lesions were observed under electronic nasopharyngeal microscopy:Lesions were located in the anterior 1/3 of the vocal cords(13/54,24.1%)in 13 patients,and bilateral vocal cords were involved in lesions in 42patients(42/54,77.8%),and unilateral vocal cords were involved in lesions in 12 patients(12/54,22.2%).However 1 patient’s lesion involved anterior vocal cord union(1/54,1.8%),and wide base polyps were found in 16patients(16/54,29.6%).One patient had bilateral giant polyps(1/54,1.8%).Treatment plan: Forty-nine patients received laser resection of vocal cord polyps under general anesthesia supported laryngoscope,and 3patients received vocal cord polypectomy under local anesthesia electronic laryngoscope.In addition,2 patients received vocal cord new biological biopsy under the electronic laryngoscope,because they requiredconservative treatment,outpatient follow-up and no surgery.Pathological examination: The postoperative pathological examination of 52 patients showed polyp or accord with vocal cord polyp.The pathological examination of 2 patients with vocal cord neoplasm showed polyp.ConclusionVocal polyp is a benign lesion that occurs in the larynx,which is also a special type of laryngeal polyp.Hoarseness is often the main clinical manifestation.However,when vocal polyp covers the glottis or vocal polyp is embedded in the glottis,it may cause the patient’s voice loss.In general,the most common and most influential symptom of vocal cord polyps is hoarseness,which often seriously affects the quality of life of patients.Therefore,active diagnosis and treatment should be given.Clinically,there are many ways to treat vocal cord polyps,including surgical excision,drug therapy and voice training.However,there is a certain risk of recurrence after vocal cord polyp surgery,and many factors can lead to the recurrence after vocal cord polyp surgery,including unreasonable use of voice,smoking,drinking,laryngopharyngeal reflux,chronic inflammatory stimulation,and the choice of surgical methods.This study also showed that unreasonable use of voice,smoking,drinking,laryngopharyngeal reflux and other factors are closely related to the recurrence of vocal cord polyps after surgery.Therefore,in order to reduce the recurrence of vocal cord polyps aftersurgery,patients should be guided to use voice reasonably after surgery,pay attention to sound rest and correct voice,and actively participate in voice training to improve the way of pronunciation.In addition,patients should quit smoking and drinking after surgery,to avoid a cold,at the same time for patients with gastroesophageal reflux disease,need active treatment,as far as possible to avoid recurrence of vocal cord polyps.