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.