Laser in treatment of laryngeal amyloidosis

Behranwala, Kasim A; Asgar, B. Ali; Borges, Anita M.; Marfatia, P. T.

doi:10.1007/bf02968774

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…7 Amyloidosis can be primary or secondary. 1,7 Primary type of amyloidosis is usually idiopathic (56 %), whereas the secondary form is often associated with an infectious process or chronic inflammatory (5%). 1 Amyloidosis can be local or systemic.…”

Section: Discussionmentioning

confidence: 99%

“…1,7 Primary type of amyloidosis is usually idiopathic (56 %), whereas the secondary form is often associated with an infectious process or chronic inflammatory (5%). 1 Amyloidosis can be local or systemic. The larynx is hardly ever the first location of systemic amyloidosis; but due to its potentially ominous prognosis, the latter should be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…Primary amyloidosis is an idiopathic condition (56%), while the secondary one is related to chronic inflammatory or infectious process (5%). 1 Laryngeal amyloidosis has a recurrent/persistent process and its recurrence is the norm rather than the exception. 2 Laryngeal amyloidosis is an uncommon benign disease ranging between 0.2 and 1.2% of all benign lesions of larynx.…”

mentioning

confidence: 99%

“…Stridor and dyspnoea could develop in patients with extensive involvement. 1,2 Histologically, amyloid can be established with Congo Red staining which shows classic bright green birefringence when seen under polarizing light microscopy as well as immunohistochemical stains. 1 Treatment aims to provide consistent or improvise the voice quality, to support laryngeal airway, and prevent recurrences.…”

mentioning

confidence: 99%

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Primary Laryngeal Amyloidosis and CO2 Laser as the Treatment Modality

Bhujel

Bhowmick²,

Gandhi³

et al. 2021

BJOHNS

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Introduction Amyloidosis is brought about by intracellular and/or extracellular accumulation of insoluble abnormal amyloid fibrils that alters the normal function of the tissues. Localized laryngeal amyloidosis is a rare disease which lacks long-term follow-up studies. It is prone to recurrence; hence meticulous excision is required. We are doing this study to analyse clinical features of primary laryngeal amyloidosis, the subsites commonly found in, and the effectiveness of CO2 laser as treatment modality. Materials and Methods It is a retrospective study of 13 patients diagnosed as Primary Laryngeal Amyloidosis in between 2005 to 2018, where clinical features, histologic and immuno-histochemical patterns of the patients were evaluated. Systemic amyloidosis was ruled out by the non-appearance of Bence-Jones proteins in urine and serum electrophoresis examination. Systemic workups were pursued during the follow-up. The patients were followed up 3 monthly for the first year, then 6 monthly after that, for 3 years. The last patient who underwent the surgery was in the 2018 and had just finished his 2nd follow up, while the rest have been followed up for 3 years. Results Hoarseness was the most common complaint in all the patients. The subsites most common for amyloid deposition were seen in the true vocal cords followed by supraglottis, anterior commissure, ventricle and the subglottis. Microscopically, the amyloid was deposited within the submucosa surrounded by lymphoplamocytic infiltration. All cases were treated with microlaryngoscopic CO2 Laser excision. With the exception of one patient, the rest had no recurrence. Conclusion Primary Laryngeal Amyloidosis is an uncommon benign disease that has a predisposition for recurrence. With use of CO2 laser as the primary treatment modality, the percentage of recurrence has drastically reduced. Systemic involvement should be ruled out. A frequent follow-up of the patients is desirable for early detection of recurrences. Laser is a novel treatment of laryngeal amyloidosis.

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