Larinksin Benign Lezyonları
Özet
Larinksin benign lezyonları ses kısıklığı ile başvuran hastalarda sık görülen patolojiler arasındadır. En sık görülen lezyonlar vokal kord nodülleri, vokal kord polipleri, Reinke ödemi, intrakordal kistler ve vokal granülomlardır. Bu lezyonların gelişiminde fonotravma, sigara kullanımı ve laringofaringeal reflü önemli rol oynar. Tanı genellikle endoskopik muayene ve videostroboskopi ile konulur. Tedavide ses hijyeni ve ses terapisi ilk basamak olup, gerekli durumlarda fonocerrahi uygulanabilir.
Benign lesions of the larynx are common pathologies in patients presenting with dysphonia. The most frequently encountered lesions include vocal fold nodules, vocal fold polyps, Reinke’s edema, intracordal cysts, and vocal granulomas. Phonotrauma, smoking, and laryngopharyngeal reflux play important roles in their development. Diagnosis is mainly based on endoscopic examination and videostroboscopy. Voice hygiene and voice therapy are the first-line treatments, while phonosurgical interventions may be required in selected cases.
Referanslar
Martins RH, do Amaral HA, Tavares EL, et al. Voice Disorders: Etiology and Diagnosis. Journal of Voice. 2016;30(6):761.e1-761.e9. doi:10.1016/j.jvoice.2015.09.017
Van Houtte E, Van Lierde K, D'Haeseleer E, et al. The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia. Laryngoscope. 2010;120(2):306-312. doi:10.1002/lary.20696
Coyle SM, Weinrich BD, Stemple JC. Shifts in relative prevalence of laryngeal pathology in a treatment-seeking population. Journal of Voice. 2001;15(3):424-440. doi:10.1016/S0892-1997(01)00043-1
Martins RH, Defaveri J, Custódio Domingues MA, de Albuquerque E Silva R, Fabro A. Vocal fold nodules: morphological and immunohistochemical investigations. Jornal of Voice. 2010;24(5):531-539. doi:10.1016/j.jvoice.2009.01.002
Nunes RB, Behlau M, Nunes MB, et al. Clinical diagnosis and histological analysis of vocal nodules and polyps. Brazilian Journal of Otorhinolaryngology. 2013;79(4):434-440. doi:10.5935/1808-8694.2013007
Baali MH, Shaheen MH, Khan MF, et al. Optimizing Management Strategies for Vocal Cord Nodules: A Systematic Review. Cureus. 2024;16(12):e75916. doi:10.7759/cureus.75916
Hassan ES, Kamel NA, Mohamed HA. Intralesional steroid injection versus voice therapy for the management of early vocal fold nodules in female patients: a randomized controlled trial. European Archives of Oto-Rhino-Laryngology. Published online December 29, 2025. doi:10.1007/s00405-025-09923-7
Barsties V Latoszek B, Watts CR, Hetjens S, et al. The Efficacy of Different Voice Treatments for Vocal Fold Polyps: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2023;12(10):3451. doi:10.3390/jcm12103451
Pontes P, Kyrillos L, Behlau M, De Biase N, Pontes A. Vocal nodules and laryngeal morphology. Journal of Voice. 2002;16(3):408–414. doi: 10.1016/S0892-1997(02)00112-1
Vasconcelos D, Gomes AOC, Araújo CMT. Vocal Fold Polyps: Literature Review. International Archives of Otorhinolaryngology. 2019;23(1):116-124. doi:10.1055/s-0038-1675391.
Petrovic-Lazic M, Jovanovic N, Kulic M, et al. Acoustic and perceptual characteristics of the voice in patients with vocal polyps after surgery and voice therapy. Journal of Voice. 2015;29(2):241-246. doi:10.1016/j.jvoice.2014.07.009
Abraham S, Chettuvatti K, Virk RS. Exploring Benign Vocal Cord Polyp Treatment: A Holistic Analysis of Plasma Ablation and Laser Excision Phonosurgery Practices Incorporating Subjective, Objective, and Videostroboscopic Assessments. Indian Journal of Otolaryngology – Head & Neck Surgery. 2025;77(8):3049-3055. doi:10.1007/s12070-025-05632-z
Pereira AM, Dassie-Leite AP, Pereira EC, et al. Auditory perception of lay judges about gender identification of women with Reinke's edema. Codas. 2018;30(4):e20170046. doi:10.1590/2317-1782/20182017046
Gugatschka M, Darnhofer B, Grossmann T, et al. Proteomic Analysis of Vocal Fold Fibroblasts Exposed to Cigarette Smoke Extract: Exploring the Pathophysiology of Reinke's Edema. Molecular & Cellular Proteomics. 2019;18(8):1511-1525. doi:10.1074/mcp.RA119.001272
Schyberg YM, Bork KH, Sørensen MK, et al. "Cold-Steel" Phonosurgery of Reinke Edema Evaluated by the Multidimensional Voice Program. Journal of Voice. 2018;32(2):244-248. doi:10.1016/j.jvoice.2017.04.020
Dewan K, Chhetri DK, Hoffman H. Reinke's edema management and voice outcomes. Laryngoscope Investig Otolaryngol. 2022;7(4):1042-1050. doi:10.1002/lio2.840
Matar N, Amoussa K, Verduyckt I, et al. CO2 laser-assisted microsurgery for intracordal cysts: technique and results of 49 patients. European Archives of Oto-Rhino-Laryngology. 2010;267(12):1905-1909. doi:10.1007/s00405-010-1315-y
Izadi F, Ghanbari H, Zahedi S, et al. An Island Flap Technique for Laryngeal Intracordal Mucous Retention Cysts. Iranian Journal of Otorhinolaryngology. 2015;27(82):337-342.
Devaney KO, Rinaldo A, Ferlito A. Vocal process granuloma of the larynx-recognition, differential diagnosis and treatment. Oral Oncology. 2005;41(7):666-669. doi:10.1016/j.oraloncology.2004.11.002
Ding J, Lou Z. Can vocal process granuloma location forecast the efficacy of anti-reflux treatment?. J Laryngol Otol. 2023;137(2):178-185. doi:10.1017/S0022215122000457
Ford CN, Inagi K, Khidr A, et al. Sulcus vocalis: a rational analytical approach to diagnosis and management. Annals of Otology, Rhinology & Laryngology. 1996;105(3):189-200. doi:10.1177/000348949610500304
Rajasudhakar R. Effect of voice therapy in sulcus vocalis: A single case study. S Afr J Commun Disord. 2016;63(1):e1-e5. doi:10.4102/sajcd.v63i1.146
Lee A, Sulica L, Aylward A, et al. Sulcus vocalis: A new clinical paradigm based on a re-evaluation of histology. Laryngoscope. 2016;126(6):1397-1403. doi:10.1002/lary.25732
Hirano S, Kawamoto A, Tateya I, et al. A phase I/II exploratory clinical trial for intracordal injection of recombinant hepatocyte growth factor for vocal fold scar and sulcus. Journal of Tissue Engineering and Regenerative Medicine. 2018;12(4):1031-1038. doi:10.1002/term.2603
Sueyoshi S, Umeno H, Kurita T, et al. Long-term outcomes of basic fibroblast growth factor treatments in patients with vocal fold scarring, aged vocal fold, and sulcus vocalis. Auris Nasus Larynx. 2021;48(5):949-955. doi:10.1016/j.anl.2021.02.004
Lepine C, Leboulanger N, Badoual C. Juvenile onset recurrent respiratory papillomatosis: What do we know in 2024 ?. Tumour Virus Research. 2024;17:200281. doi:10.1016/j.tvr.2024.200281.
Lépine C, Voron T, Berrebi D, et al. Juvenile-Onset Recurrent Respiratory Papillomatosis Aggressiveness: In Situ Study of the Level of Transcription of HPV E6 and E7. Cancers (Basel). 2020;12(10):2836. doi:10.3390/cancers12102836
Levinson J, Karle WE. Laryngeal Papillomatosis. Cancers (Basel). 2025;17(6):929. Published 2025 Mar 10. doi:10.3390/cancers17060929
Appiah-Thompson P, Hanson NAM, Quansah K, et al. Congenital Laryngeal Hemangioma: A Case Report of a Rare Presentation. Cureus. 2023;15(2):e34814. doi:10.7759/cureus.34814
Alshaya H, Alhejji A, Aldkhyyal A, Mesallam TA. Management of adult laryngeal hemangioma with CO2 laser. Saudi Medical Journal. 2021;42(11):1252-1253. doi:10.15537/smj.2021.42.11.20210319
Almothahbi A, Bukhari M, Almohizea M, et al. Recent updates in laryngeal hemangioma management: a scoping review. European Archives of Oto-Rhino-Laryngology. 2024;281(5):2211-2222. doi:10.1007/s00405-023-08378-y
