Arzu TÜZÜNER, Zeynep KIZILKAYA, Hatice KARADAŞ, Noyan KESKİN

TİROİD İNCE İĞNE ASPİRASYONU SONRASI OLUŞAN HEMOROJİK KORD VOKAL POLİBİ: VAKA TAKDİMİ

Hemorojik vokal kord polipleri hastalarda ses kalitesinde bozulmaya yol açan gerçek vokal kordların benign lezyonlarıdırlar. Videolaringostroboskopik muayenede bu lezyonlar kırmızımsı renkte, genellikle asimetrik midkord lezyonları olarak değişken şekil ve boyutta izlenirler. Genellikle rüptüre yatkın belirgin kapiller kan damarları bu hemorojik olayların oluşmasına yol açsa da iatrojenik travma da kanamayı tetikleyen sebepler arasındadır. Olgumuz, kulak-burun-boğaz kliniğimize tiroid nodülü nedeniyle yapılan ince iğne aspirasyonu sonrası akut gelişen ses kısıklığı nedeniyle refere edilen 44 yaşında bayan hastadır. Yapılan laringostroboskopik muayene ile vokal korda hemorojik polip oluşumu izlenmiştir. Hastaya antireflü tedavi ve vokal hijyen terapisi uygulanmıştır. Üçüncü ayda konservatif tedavi ile lezyon kaybolmuştur. Tiroid ince iğne aspirasyon biyopsisine bağlı gerçek vokal kordlarda oluşan travma nadir görülen bir komplikasyon ve iyatrojenik bir sebeptir.

HEMORRHAGIC VOCAL FOLD POLYP FOLLOWING THYROID FINE NEEDLE ASPIRATION BIOPSY: CASE REPORT

Hemorrhagic vocal cord polyps are benign lesions of true vocal fold effecting voice quality of the patients . On the videolaryngostroboscopic examination, these lesions are observed as reddish, asymmetric mid-fold lesions with variety of shape and size. Usually a prominent capillary blood vessel which has propensity to rupture, resulting in hemorrhagic events but iatrogenic tissue trauma may also may trigger the hemorrhagia. We would like to present a forty-four years old female who referred to our otolaryngology clinic for dysphonia complain immediately after fine needle aspiration biopsy for thyroid nodule . Our clinical assesment with laryngostoboscopic exmaniation revealed the pathology as hemorrhagic vocal cord polyp.Patient was put on antireflux treatment and vocal hygiene theraphy. Patient's condition resolved with conservative therapy on the third month of treatment. Acute trauma to true vocal folds due to thyroid FNA was a rare complication and an iatrogenic cause.

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1)Nakagawa H, Miyamoto M, Kusuyama T, Mori Y, Fukuda H. Resolution of Vocal Fold Polyps With Conservative Treatment. J Voice. 2012; 26: 107-10.
2)Gray SD, Titze I, Lusk RP. Electron microscopy of hyperphonated canine vocal cords. J Voice. 1987; 1: 109-115.
3)Gray SD, Hammond E, Hanson DF. Benign pathologic responses of the larynx. Ann Otol Rhinol Laryngol. Jan 1995; 104: 13-8.
4)Klein AM, Lehmann M, Hapner ER, Johns MM. Spontaneous resolution of hemorrhagic polyps of the true vocal fold. J Voice. 2009; 23: 132-135.
5)Hochman II, Zeitels SM. Phonomicrosurgical management of vocal fold polyps: the subepithelial microflap resection technique.J Voice. 2000; 14: 112-8.
6)Wang CT, Huang TW, Liao LJ, Lo WC, Lai MS, Cheng PW. Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy.JAMA Otolaryngol Head Neck Surg. 2013; 139: 610-6.
7)Gökcan KM, Dursun G. Vascular lesions of the vocal fold.Eur Arch Otorhinolaryngol. 2009; 266: 527-33.
8)Jackson-Menaldi CA, Knoll EP, Fishman RA, Holland RW. Hemorrhagic polyp of the vocal fold. Ear Nose Throat J. 2004; 83: 671-2.
9)Cohen SM, Garrett CG. Utility of voice therapy in the management of vocal fold polyps and cysts. Otolaryngol Head Neck Surg. 2007; 136: 742-746.
10)Wang CT, Liao LJ, Lai MS, Cheng PW. Comparison of benign lesion regression following vocal fold steroid injection and vocal hygiene education. Laryngoscope. Feb; 124: 510-5.
11)Dursun G, Karatayli-Ozgursoy S, Ozgursoy OB, Tezcaner ZC, Coruh I, Kilic MA. Influence of the macroscopic features of vocal fold polyps on the quality of voice: a retrospective review of 101 cases.Ear Nose Throat J. 2010; 89: 12-7.
12)Yildar M, Demirpolat G, Aydin M.Acute suppurative thyroiditis accompanied by thyrotoxicosis after fine-needle aspiration: treatment with catheter drainage.J Clin Diagn Res. 2014; 8: 12-4.
13)Lee YJ, Kim DW, Jung SJ.Comparison of sample adequacy, pain-scale ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience. Endocrine. 2013; 44: 696-701.