The Correlation Analysis Of Benign Lesion Location,Pathological Type And Curative Effect Of Vocal Cords

Objective:The correlation between benign lesion location and pathological type,surgical effect and prognosis was analyzed,and the risk factors of benign lesion were summarized to guide future clinical treatment and the expected evaluation of therapeutic effect.Methods:The present study was divided into:(1)the first one-third group according to the growth location of vocal cord tumors(those with tumors located in the junction between the first one-third and the middle one-third to the former union were included in this group).(2)The middle third group(after the junction of the first third of the middle third to the junction of the second third of the middle).(3)The third third group(after the third third of the junction to the vocal cord after the process into this group).(4)Vocal cord whole growth a group.They were divided into two groups according to gender.They were divided into groups of 20-30 years old according to age;31 to 40 age group;41 to 50 years old group;51 to 60 years old group.Patients were divided into groups of less than 1 year and greater than or equal to 1 year according to the length of illness.According to the postoperative pathological examination results,the patients were divided into simple polyp group,polyp group and/or combined with other pathological changes group.According to the postoperative efficacy,the patients were divided into three groups:the cured group.the improved group and the ineffective group.Detailed medical history was inquired preoperatively,routine fiberoptic laryngoscopy and routine preoperative examination under general anesthesia.The surgical method was extraction of vocal cord masses by nasal endoscope combined with laryngoscope.Standardized perioperative treatment was used after surgery,including anti-inflammatory treatment,glucocorticoid atomization,oral proton pump inhibitor,voice rest for a week.Three months after the operation,the surgical effect was evaluated.(1)Cure:the patient's hoarseness or other symptoms completely disappeared(the voice returned to normal),laryngoscope saw smooth and flat vocal cord edges,vocal cord activities closed well.(2)Better:hoarseness and other symptoms improved significantly,laryngoscopy saw a slight edema of the vocal cords,glottis can be closed.(3)Invalid:hoarseness or other symptoms without obvious improvement or even aggravation,laryngoscope saw vocal cord hyperemia and hypertrophy,tumor recurrence,glottis incomplete closure.Results:Patients with invalid prognosis were considered as positive cases,while those who got better and cured were considered as negative cases.Gender,age,course of disease,location of growth and pathological results were analyzed by multivariate Logistic regression.Selected five clinical factors studied,the factors to be included in the model for location group,OR a value of 2.308(1.736,3.068),the results of the analysis suggest the vocal cords benign lesion location is one of the important risk factors influencing surgical curative effect,the lesion location is located in the front and middle of the surgical curative effect is best,efficient(including recovery and improvement)can reach more than 90%.When the lesion is located in the latter third and the whole course,the curative effect is poor.The chi-square test was used to analyze the correlation between the lesion location and pathological type,with statistical significance.The lesion of pure vocal cord polyp accounted for 74.7%in 344 patients,and the lesion of vocal cord polyp was the main lesion in the patients with anterior,middle and complete vocal cord lesions.The number of patients with the pathological type of the first third of the lesions was the most,accounting for 57.8%of the total number of cases and 80.6%of the total number of lesions.The pathological changes of one third of the patients with vocal cord lesions and the patients with whole-course lesions were that the single vocal cord polyp accounted for 56.8%and 81.5%of the middle and whole-course lesions respectively.The latter third had the lowest number of patients,but the main pathological manifestations were inflammatory granuloma and vocal cord polyp and/or combined with other pathological changes,such as amyloidosis,vascular polyp and vocal cord ulcer,accounting for 57.7%of the lesion location.Conclusions:(1)the prevalence of male was higher than female.(2)The prevalence of middle-aged men and women was higher than that of the youth group and the elderly group.(3)The number of patients with the disease course<1 year exceeds the number of patients with the disease course 1 year.(4)Lesion location is an important risk factor for benign vocal cord lesion surgery.The curative effect was the best in the first and middle third of lesions,but the curative effect was not good in the whole course and the last third of lesions.(5)The larger the scope of the disease,the less ideal postoperative symptom improvement,the latter third of the disease is more likely to relapse.(6)The pathological type and location of benign vocal cord lesions have statistical significance.The main pathological types of the anterior and middle vocal cords and the whole process were simple vocal cord polyp changes.The pathological types of the latter third of the vocal cords were inflammatory granuloma,vocal cord polyp and/or combined with other pathological changes,such as amyloidosis,vascular polyp,and vocal cord ulcer changes.