Diagnosis and physiopathology of laryngeal deposits in autoimmune disease

We report the clinical features and pathology of a previously unreported fo rm of vocal fold disease seen in 4 patients, 3 of whom were diagnosed as au toimmune disease. The characteristic features of these lesions were found a s bilateral transverse lesions in the mid portion of the vocal folds. The p atients had dysphonia and diplophonia. Stroboscopic examinations showed 180 -degree phase shifts between the anterior and posterior portion of the voca l folds. Case 1 had systemic lupus erythematosus, case 2 had Hashimoto's th yroiditis, and case 3 had progressive systemic sclerosis. Prior to the onse t of hoarseness, autoimmune antibody titers were increased. These cases nee d differential diagnosis from vocal fold nodules and cysts. Two cases were recurrent after endoscopic surgery, 1 recurring 3 times. Glucocorticoid was effective in preventing the recurrence in the early phase. Recurrence may have occurred because the surgical strategy was the same as that used for v ocal fold nodules or cysts.