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Alterations of mucosa of the larynx and hypopharynx in patients with mucopolysaccharidoses

Published online by Cambridge University Press:  17 December 2015

A Keilmann*
Affiliation:
Voice Care Center, Bad Rappenau, Germany
F Bendel
Affiliation:
Division of Communication Disorders, Department of ORL, University Medical Center, Mainz, Germany
S Nospes
Affiliation:
Division of Communication Disorders, Department of ORL, University Medical Center, Mainz, Germany
C Lampe
Affiliation:
Center for Rare Diseases, Department of Child and Adolescent Medicine, Horst Schmidt Klinik, Wiesbaden, Germany
A K Läßig
Affiliation:
Division of Communication Disorders, Department of ORL, University Medical Center, Mainz, Germany
*
Address for correspondence: Prof Annerose Keilmann, Stimmheilzentrum Bad Rappenau, Salinenstr. 43, 74906 Bad Rappenau, Germany Fax: +49 7264 808 4570 E-mail: [email protected]

Abstract

Objective:

This study aimed to: assess the mucosal alterations of the larynx and hypopharynx typical for mucopolysaccharidoses, in a standardised manner; compare the severity in different subtypes of mucopolysaccharidoses; and monitor the effect of an enzyme replacement therapy.

Methods:

A classification for mucosal alterations of the larynx and hypopharynx was developed and utilised in 55 patients with mucopolysaccharidoses. Fifteen patients who started treatment with enzyme replacement therapy were followed longitudinally.

Results:

The most severe alterations were seen in the posterior region of the larynx and the arytenoids, and in the region of the false vocal folds. The alterations were most severe in patients with mucopolysaccharidosis II. No clear trend was observed in the patients who received enzyme replacement therapy.

Conclusion:

Quantification of mucosal alterations of the hypopharynx and larynx in mucopolysaccharidoses patients can provide information about the disease's natural process and about the efficacy of enzyme replacement therapy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Parts of this paper were presented at the 30th Annual Meeting of the German Society for Phoniatrics and Pedaudiology, 20–22 September 2013, Bochum, Germany.

References

1Muenzer, J. The mucopolysaccharidoses: a heterogeneous group of disorders with variable pediatric presentations. J Pediatr 2004;144:S27–34CrossRefGoogle ScholarPubMed
2Young, ID, Harper, PS. Mild form of Hunter's syndrome: clinical delineation based on 31 cases. Arch Dis Child 1982;57:828–36CrossRefGoogle ScholarPubMed
3Mendelsohn, NJ, Harmatz, P, Bodamer, O, Burton, BK, Giugliani, R, Jones, SA et al. Importance of surgical history in diagnosing mucopolysaccharidosis type II (Hunter syndrome): data from the Hunter Outcome Survey. Genet Med 2010;12:816–22CrossRefGoogle ScholarPubMed
4Keilmann, A, Nakarat, T, Bruce, IA, Molter, D, Malm, G. Hearing loss in patients with mucopolysaccharidosis II: data from HOS – the Hunter Outcome Survey. J Inherit Metab Dis 2012;35:343–53CrossRefGoogle ScholarPubMed
5Keilmann, A, Malm, G. Head and neck diseases in patients with M. Hunter (Mucopolisaccharidosis II) [in German]. GMS Curr Posters Otorhinolaryngol Head Neck Surg 2010;6:Doc60Google Scholar
6Walker, R, Belani, KG, Braunlin, EA, Bruce, IA, Hack, H, Harmatz, PR et al. Anaesthesia and airway management in mucopolysaccharidosis. J Inherit Metab Dis 2013;36:211–19CrossRefGoogle ScholarPubMed
7Cormack, RS, Lehane, J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984;39:1105–11CrossRefGoogle ScholarPubMed
8Mallampati, SR, Gatt, SP, Gugino, LD, Desai, SP, Waraksa, B, Freiberger, D et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985;32:429–34CrossRefGoogle ScholarPubMed
9Semenza, GL, Pyeritz, RE. Respiratory complications of mucopolysaccharide storage disorders. Medicine (Baltimore) 1988;67:209–19CrossRefGoogle ScholarPubMed
10Belani, KG, Krivit, W, Carpenter, BL, Braunlin, E, Buckley, JJ, Liao, JC et al. Children with mucopolysaccharidosis: perioperative care, morbidity, mortality, and new findings. J Pediatr Surg 1993;28:403–10CrossRefGoogle ScholarPubMed
11Simmons, MA, Bruce, IA, Penney, S, Wraith, E, Rothera, MP. Otorhinolaryngological manifestations of the mucopolysaccharidoses. Int J Pediatr Otorhinolaryngol 2005;69:589–95CrossRefGoogle ScholarPubMed
12Walker, RW, Darowski, M, Morris, P, Wrath, JE. Anaesthesia and mucopolysaccharidosis. Anaesthesia 1994;49:1078–84CrossRefGoogle Scholar
13Berger, KI, Fagondes, SC, Giugliani, R, Hardy, KA, Lee, KS, McArdle, C et al. Respiratory and sleep disorders in mucopolysaccharidosis. J Inherit Metab Dis 2013;36:201–10CrossRefGoogle ScholarPubMed
14Yeung, AH, Cowan, MJ, Horn, B, Rosbe, KW. Airway management in children with mucopolysaccharidoses. Arch Otolaryngol Head Neck Surg 2009;135:73–9CrossRefGoogle ScholarPubMed
15Harmatz, P, Whitley, CB, Waber, L, Pais, R, Steiner, R, Plecko, B et al. Enzyme replacement therapy in mucopolysaccharidosis VI (Maroteaux-Lamy syndrome). J Pediatr 2004;144:574–80CrossRefGoogle ScholarPubMed
16Muenzer, J, Wraith, JE, Beck, M, Giugliani, R, Harmatz, P, Eng, CM et al. A phase II/III clinical study of enzyme replacement therapy with idursulfase in mucopolysaccharidosis II (Hunter syndrome). Genet Med 2006;8:465–73CrossRefGoogle ScholarPubMed