Hyperkeratosis of the Larynx

후두각화증에 대한 임상적 고찰

The clinical entity referred to as epithelial hyperplasia has been called by various terms : keratosis, hyperkeratosis, pachydermia, acanthosis, leukoplakia, hyperkeratotic laryngitis. The metaplasia and keratinization of the layngeal mucosa are associated with the subsequent appearance of invasive epidermoid carcinoma. Therefore. frequent and prolonged periods of observation and histologic study on keratosis of the larynx are essential. A retrospective review of 18 patients with laryngeal hyperkeratosis seen at Department of Otolaryngology Yondong Severance Hospital during the 7 years period was completed. The results are summarized as follows : 1) The incidence was much higher in males(22 patients) than in females(4 patients) 2) The peak age of male was 4th decades and the peak age of female was 4th. 5th decades. 3) The chief complaint of the patients was hoarseness in all cases. 4) The average duration of symptoms was less than 24 months for 19 cases(73.1%). 5) 17 patients(65.4%) was smokers and duration of smoking was 10~20 years for 10 cases(38.8%). 6) On histological examination. the lesions were classified into three types: simple hyperplasia(61.5%). dysplasia(26.9%) and carcinoma in situ(2 cases). 7) The recurrence rates was 9 cases(34.6%) and transformation rate into invasive carcinoma was 1 case(3.8%).

1983년도부터 1990년까지 7년 동안 연세대학교 의과대학 영동세브란스병원 이비인후과에 내원하여 후두각화증으로 조직학적 확진을 거친 환자를 대상으로 후향적 조사를 실시하여 다음과 같은 결과를 얻었다. 1) 총 환자수는 26명으로서 남녀비는 22:4로 남자에서 월등히 높았으며 연령별로는 남자는 50대, 여자는 50대 및 60대에서 빈도가 높은 것으로 나타났다. 2) 침윤성 암 1례를 포함해서 이형성 후두각화증을 보인 예는 총 10례였는데 역시 남자에서 높은 빈도를 보였다. 3) 조직학적으로 크게 3가지로 분류하였는데 단순성 각화증이 16례(61.5%), 국소적 이형성이 있는 각화증이 7례(26.9%)이었고 상피내암(Carcinoma in situ)은 2례, 침윤성 암(Carcinoma) 1례로 확인되었다. 4) 주 증상으로는 쉰 목소리를 전례에서 호소하였으며 증상이 나타나면서 내원하기까지의 지속시간이 24개월 이하가 19례(73.1%)로 조사되었다. 5) 흡연 경력은 17례(65.4%)이며 10-20년이 10례(38.8)로 많은 빈도수를 보였다. 6) 재발은 모두 9례로서 1례가 침윤성 암으로 재발하였다.