RESEARCH - Bamboo node: primary vocal fold lesion as evidence of autoimmune disease

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J Voice. 2001 Sep;15(3):441-50.

Bamboo node: primary vocal fold lesion as evidence of autoimmune disease.

Murano E, Hosako-Naito Y, Tayama N, Oka T, Miyaji M, Kumada M, Niimi S.

Department of Otolaryngology, University of Tokyo, Japan.

Descriptions of vocal fold lesions related to autoimmune diseases are

rare in the literature, and focus mainly on rheumatoid nodules. This

is the first report in which autoimmune diseases were promptly

suspected by the observation of a unique white transverse submucosal

lesion in the vocal fold during clinical examination. This lesion,

reported only in autoimmune disease, has been called the bamboo node

and its features are different from those of rheumatoid nodules. We

report here on two patients who did not have a diagnosis of systemic

disease before investigation of their main complaint of hoarseness. At

the patients' first visit, vocal fold bamboo nodes were seen in the

vocal fold and the otolaryngologist suspected the presence of an

autoimmune disease. We requested clinical investigation to clarify our

suspicion that there was an underlying systemic disease. After the

investigation, both patients were shown to have autoimmune disease,

Sjögren's syndrome and systemic lupus erythematous, respectively. This

paper emphasizes the important role of the otolaryngologist in the

detection of these unique lesions in the vocal folds through the

conventional laryngeal methods. These methods consisted of direct

observation with a rigid laryngeal endoscope and investigation of the

patient's distinctive vibratory pattern by means of laryngeal

stroboscopy. The method of treatment we used to obtain the best

outcome in terms of voice improvement is also discussed.

PMID: 11575639

http://www.ncbi.nlm.nih.gov/pubmed/11575639

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