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Larynxpapillomatose

Ätiologie, Diagnostik und Therapie

Laryngeal papillomatosis

Etiology, diagnostics and therapy

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Zusammenfassung

Papillome sind Tumoren, welche von der Schleimhaut ihren Ursprung nehmen. Diese können im Bereich der Nase/Nasennebenhöhlen, der Mundhöhle, des Oropharynx, des Larynx, der Trachea und der Haut vorkommen. Meist handelt es sich um Zufallsbefunde, da Papillome selten Beschwerden machen. Eine Ausnahme bildet die Larynxpapillomatose, welche mit Stridor, Dyspnoe und Heiserkeit einhergeht. Ursächlich wird eine virale Genese diskutiert – hier v. a. eine Infektion mit humanen Papillomaviren (HPV). Eine mechanische Genese bei Affektion von Nase und Mundhöhle bzw. Oropharynx kann nicht ausgeschlossen werden. Allen Papillomen, unabhängig von ihrer Lokalisation, sind die Rezidivfreudigkeit sowie die Potenz zur malignen Entartung gemeinsam. Therapie der Wahl ist die komplette Exzision. Bei der Larynxpapillomatose wird vielfach die Laservaporisation bzw. -exzision mit dem CO2-Laser bevorzugt. Da die chirurgische Intervention aufgrund der Rezidive oft wiederholt durchgeführt werden muss, werden v. a. bei der Larynxpapillomatose adjuvante Therapien mit der Zielsetzung angewendet, die Rezidivrate zu senken und die Intervalldauer zu verlängern.

Abstract

Papillomas are rare tumors that originate from the mucosa. They may appear in the nose, paranasal sinuses, oral cavity, larynx, trachea, or the skin. Papillomas are mainly asymptomatic and are therefore mostly diagnosed coincidentally. In contrast, laryngeal papillomatosis may cause stridor, dyspnoea, and hoarseness. A viral cause of the disease seems likely, especially human papilloma virus. Mechanical irritation is also a possible reason when the nose, oral cavity, or oropharynx is affected. All papillomas, independent of their origin, may recur, and have the possibility of malignant degeneration in common. The therapy of choice is complete surgical excision. Regarding laryngeal papillomatosis, laser vaporisation or excision using the CO2 laser is recommended. Because retreatments using conventional modalities are frequently necessary, especially in the case of laryngeal papillomatosis, adjuvant therapies are applied with the aim of reducing the recurrence rate and prolonging the interval between treatments.

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  1. Abteilung für Hals-, Nasen- und Ohrenheilkunde, Klinikum Dachau, Krankenhausstraße 15, 85221, Dachau, Deutschland

    M. Andratschke

  2. Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Klinikum Großhadern und Innenstadt, Ludwig-Maximilians-Universität, München, Deutschland

    C. Betz & A. Leunig

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  1. M. Andratschke
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Andratschke, M., Betz, C. & Leunig , A. Larynxpapillomatose. HNO 56, 1190–1196 (2008). https://doi.org/10.1007/s00106-008-1711-4

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