โ Scribed by Thomas S. Higgins; Justin C. Cohen; John T. Sinacori
No coin nor oath required. For personal study only.
To perform a systematic pooledโdata analysis of literature data involving laryngeal mucous membrane pemphigoid (MMP).
A systematic review and pooledโdata analysis.
We conducted a systematic literature search of MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, Cochrane Database of Systematic Reviews, clinicaltrials.gov, and the National Guideline Clearinghouse databases without language restriction for studies including combinations of relevant terms. All authors independently screened the abstracts of the search results, identified articles eligible for review, and critically appraised the fullโtext studies. Pooledโdata analyses and KaplanโMeier survival analyses were conducted using SPSS version 16.0 software (SPSS Inc., Chicago, IL).
Of the 2,524 citations reviewed, the included articles consisted of 63 case reports and 10 case series reporting on 141 patients with laryngeal MMP. No clinical trials or comparative trials were found. The overall calculated prevalence of laryngeal MMP was 12.2% (95% confidence interval [CI], 11.5โ12.9%) of cases of MMP or one in 10 million persons in the general population. Mean age at laryngeal MMP onset was 59.7 years (95% CI, 57.9โ61.1 years), and the supraglottis was the most commonly affected site (84.8%, 95% CI, 82.5โ87.2%). Distribution among genders was equivalent (P = .655). The presence of antiepiligrin autoantibodies was associated with increased laryngeal involvement (Odds ratio 7.9, 95% CI, 3.9โ16.0). The overall 5โyear relative survival rate was 92.4% (standard error, 8.4) with a followโup range of 1 to 221 months. Standard medical therapy alone occasionally improved the condition; however, relapses were frequent, and 10.5% eventually required tracheostomy. Laryngeal surgical interventions seemed to be effective in severe cases.
Laryngeal MMP is a rare condition that can be life threatening without proper treatment and frequent followโup. Laryngoscope, 2010
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