Bamboo Node of Vocal
Fold—– Report of 2 Cases
Muredili·Mutalifu1, †, Abula·Aizezi1,
2, †, Maheba·Aiheti3, Yang Yupin1,
Nigeremu·Abudureyimu1, 2
Yong Jun1
1Department of Otorhinolaryngology/Head and Neck
Surgery, The First Affiliated Hospital of Xinjiang Medical University,
Urumqi, China
2The First Clinical Medical Faculty, Xinjiang Medical
University, Urumqi, China
3Department of Emergency, Hospital of Xinjiang
Traditional Uyghur Medicine, Urumqi, China
Email address:
muradiru@sina.com (Muredili·Mutalifu), ablajanaziz@163.com
(Abula·Aizezi)
† Muredili·Mutalifu and Abula·Aizezi are co-first
authors.
Abstract:Vocal
fold bamboo node disease is a rare characteristic disease. Its clinical
manifestation is hoarseness. Under endoscopy, it is a fat yellow strip
disease on one or both vocal cords. Its shape is like bamboo knot. Its
disease is mainly related to autoimmune diseases, including diseases
such as systemic lupus erythematosus (SLE), rheumatoid, Sjogren’s
syndrome, etc. In this paper, the clinical data of laryngoscopy,
pathology and treatment of 2 patients with vocal cord bamboo disease
were followed up, analyzed and the relevant literature to explore the
clinical characteristics, pathogenesis, development law and treatment of
vocal fold bamboo node disease. The two patients were women, with
hoarseness as the most significant symptom, had a common cause of their
disease, which was systemic lupus erythematosus. They were treated with
oral steroids and speech therapy. One of the symptoms of this condition
is progressive, which can lead to bilateral or unilateral changes. There
is no known gold standard for treating this type of disorder, and there
is a lack of a documented method of therapy. However, the Bamboo nodes
can be helpful in identifying patients with this condition.
Keywords: Laryngeal Diseases,
Vocal
Cords, Bamboo Node, Autoimmune Diseases
Introduction
Vocal fold bamboo node disease is a rare characteristic disease. Its
clinical manifestation is mainly hoarseness. Under endoscopy, it is a
fatty yellow strip disease on one or both vocal cords. Its disease is
mainly related to autoimmune diseases. Autoimmune diseases will lead to
multi system injuries, including those to the throat. As a result of
autoimmune diseases, laryngeal lesions such as ulcers, edema,
cricoarytenoid arthritis, laryngeal paralysis, and vocal bamboo nodes
are most commonly observed. A case of SLE was described by Scarpelli et
al. In 1959. Microscopic examination showed extensive edema of lamina
propria, and invasion of tissue cells, lymphocytes, hyperplasia, and
mast cells. These lesions were originally named ”inflammatory nodules”
[1]. As early as 1993, Hosako et al. described vocal cord lesions
that resembled bamboo knots in patients with SLE, presenting as nodes
that resembled bamboo knots. Therefore, they suggested changing its name
from ”inflammatory nodule” to ”bamboo node”[2]. In this paper, the
clinical data of laryngoscopy, pathology and treatment of 2 patients
with vocal cord bamboo disease were followed up, analyzed and reviewed
the relevant literature to explore the clinical characteristics,
pathogenesis, development law and treatment of vocal fold bamboo node
disease.
2. Materials and Results
The clinical data of laryngoscope, pathology and treatment of 2 patients
with vocal cord bamboo disease in our hospital were followed up and
analyzed retrospectively. The relevant literatures published since 2020
were compared and analyzed retrospectively. The two patients were the
first diagnosed patients and were hospitalized with autoimmune diseases.
During this period, they had throat symptoms dominated by hoarseness.
3. Case Report
3.1. Case 1
A woman 25 years of age was hospitalized in the Department of
Rheumatology and immunology of our hospital in November 2015 due to
morning stiffness of both hands. She was diagnosed with systemic lupus
erythematosus and received routine first-line treatment. In 2020 Due to
hoarseness, she was consulted in our department, and her laryngoscopy
showed that there was a fatty yellow strip lesion in the front 1/3 of
the left vocal cord, with local mucosal bulge (Figure 1); the symptoms
related to SLE were well controlled at the time of treatment. It is
suggested that the sound should be stopped, and local hormone
atomization inhalation should be symptomatic, after treatment, the
symptoms of hoarseness were significantly improved after two weeks of
treatment. In November 2021, the patient came to our department again
because of hoarseness, and his laryngoscopy showed: Symmetrical fat
yellow striped lesions can be seen in the front 1 / 3 of bilateral vocal
cords, with local mucosal bulge (Figure 2). The lesions change from
unilateral bamboo node to bilateral bamboo nodes. It is recommended to
remove the lesions surgically and make a clear pathological diagnosis.
However, the patient refused the operation due to the good control of
the SLE and was given symptomatic treatment with rest and local hormone
atomization inhalation. The position of the two lesions grew clearer
during the stroboscopic test. Except for the lesion, the vocal folds
vibrated with reduced amplitude during chest voice phonation, as seen by
the stroboscopic image. There was no tendency of vibrations between the
portions of the vocal fold in front of and behind the transverse lesion
in the continuing picture of the videostroboscopy. After one week of
treatment, the symptoms of hoarseness were significantly improved, the
patient was in good health in the past, generally in good condition
after onset, without discomfort symptoms such as weight loss, and denied
the history of similar diseases in the family.