聲帶麴菌症

Aspergillosis of the Vocal Fold

蘇盈彰(Ying-Chang Su) ； 陳正蔚(Cheng-Wei Chen) ； 劉蓓麗(Phui-Ly Liew)

《台灣耳鼻喉頭頸外科雜誌》 41卷4期 (2006/08) Pp. 133-135

https://doi.org/10.6286/2006.41.4.133

摘要

聲帶麴菌症通常發生於有免疫能力缺失的患者或接受高劑量吸入性類固醇治療的氣喘病人，且常合併有全身性或呼吸系統的感染。至於原發性聲帶麴菌症在臨床上則相當罕見，其表現多為侷限性而非廣泛侵襲，故治療上並不需要加上全身性抗黴菌藥物治療。本病例為1名37歲女性，因持續聲音沙啞20天，在診所接受治療後未見改善，而至本科求治，喉纖維內視鏡顯示左側聲帶白色腫塊，胸部X光及實驗室檢查並無異常之處；在以喉顯微手術完全切除病灶後，組織病理檢查顯示表皮潰瘍併黴菌菌絲的化生，診斷為聲帶麴菌症。患者術後恢復良好，追蹤半年，並無復發跡象。因此病例罕見，特提出報告，以為診斷聲帶疾患時一個鑑別診斷的參考。

關鍵字

聲帶麴菌症 ； 聲音沙啞

並列摘要

Vocal aspergillosis is more commonly seen as part of a systemic infection involving the respiratory system in an immunocompromised host or in a host where high doses of steroids have been inhaled for asthma therapy. Primary infection of the true vocal fold with Aspergillus spp. is extremely rare clinically. In non-immunocompromised patients, vocal aspergillosis may represent colonization rather than invasion and require no systemic anti-fungal treatment. We present here the case of a 37-year-old woman with vocal aspergillosis showing no tracheobronchopulmonary extension and without any generalized immune deficit. She visited our OPD due to persistent hoarseness in spite of medication for 20 days. Direct laryngoscopy showed a whitish tumor on left vocal fold. Chest radiography and laboratory evaluation was normal. An excision biopsy by laryngomicrosurgery confirmed a diagnosis of vocal aspergillosis with an ulcerated epithelium and the presence of fungal hyphae in colonies. Local excision is an effective diagnostic tool and apparently cured the lesions in this case. No recurrence of the vocal lesion has been observed during the subsequent follow up period of six months. We report this case here because of its rarity so that it can be used as a reference for the differential diagnosis of diseases involving the vocal fold.

並列關鍵字

vocal aspergillosis ； hoarseness