standard therapeutic strategy against recurrent respiratory papillomatosis

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K11409
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Otorhinolaryngology
• Research Institution: Kyorin University
• Principal Investigator: Saito Koichiro 杏林大学, 医学部, 教授 (40296679)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 喉頭 / 乳頭腫 / 診断 / 治療 / 日帰り手術 / 希少疾患

Outline of Final Research Achievements

Total number of 87 surgeries were performed on 43 patients with laryngo-pharyngeal papillomatosis (LPP), during the project period of this study. Among multiple therapeutic options against LPP, green laser photocoagulation (GRP) could be performed as an office-based, less invasive surgery against LPP. Thus, therapeutic impact of GRP on LPP was specifically analyzed in this study.
Our study clarified significant improvement of severity score in the patients with LPP after GRP. Furthermore, gradual decrease of severity scores were observed in all the patients who had repeated GRPs. Additionally, GRP improved subjective vocal quality (voice handicap index) of the patients with lesions in their vocal folds, without damaging their objective vocal parameters (jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time). These outcomes were presented in multiple international/domestic meetings, and the findings were shared in papers, and books.

Free Research Field

喉頭音声科学

Academic Significance and Societal Importance of the Research Achievements

咽喉頭乳頭腫は、再発・多発を繰り返して複数回の手術を要し、さらに音声障害を引き起こすことで患者QOLを障害する。本研究は、この疾患に対する治療のなかでも、とくに日帰りレーザー手術に着目してその治療効果を検証した。個々の患者・家族にとって心身の負担が大きい一方で、全体の患者数が決して多くはない希少疾患の宿命として、研究が推進されにくい本疾患に関して、1つの施設で治療を行った、まとまった数の患者で検証を行った本研究の学術的価値は高い。また、今回検討した日帰りレーザー手術は、低侵襲で時間的・経済的にも負担の軽い治療によって患者の社会活動性維持に貢献できると考えられ、社会的意義も充分と考えている。