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Localized laryngeal amyloidosis: A systematic review
Kavya K Pai1, Ariel O Omiunu2, Pablo A Llerena3
1Department of Otolaryngology, Geisinger Health System, Danville, PA, USA.
American Journal of Otolaryngology
|August 2, 2022
Summary
Localized laryngeal amyloidosis (LA) is common and typically indolent. Early intervention can alleviate persistent symptoms, though recurrent disease remains a challenge.
Area of Science:
- Otorhinolaryngology
- Head and Neck Surgery
- Pathology
Background:
- Localized amyloidosis most frequently affects the larynx within the head and neck region.
- Amyloidosis involves the abnormal deposition of proteins, leading to organ dysfunction.
Purpose of the Study:
- To review the clinical characteristics, management strategies, and outcomes of localized laryngeal amyloidosis (LA).
- To compare LA features and management across different time periods, assessing treatment evolution.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, CINAHL, Embase, Cochrane Library) for biopsy-proven localized LA cases.
- Studies published between 1891 and 2021 were included, with exclusions for non-English, animal, and review articles.
Main Results:
- The study included 282 patients from 129 studies, comparing data from 1891-1999 (142 patients) and 2000-2021 (140 patients).
- Dysphonia and dyspnea were the most common symptoms. Lesions in the false vocal folds increased in prevalence in the later period. Surgical intervention was common in both periods.
- Recurrence rates were 19% (1891-2000) and 24% (2000-2021), with a mean time to recurrence of 25.4 and 34.5 months, respectively. Survival rates remained high (>97%) in both groups.
Conclusions:
- Localized laryngeal amyloidosis generally follows an indolent clinical course.
- Prompt intervention is recommended to manage chronic symptoms associated with LA.
- Managing recurrent LA presents a significant clinical challenge.
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