Bamboo Nodes as a Cause of Juvenile Dysphonia

Introduction

Vocal fold lesions related to autoimmune diseases are rheumatoid nodules, and, less frequently, bamboo nodes. The latter may also occur in the absence of systemic rheumatic disease. Mostly transverse, they are located in the middle third of the vocal cord and may be located uni- or bilateral.

Raven et al. [Raven RW et al., Ann Rheum Dis 1948; 7: 63–75] were the first to describe small submucous rheumatoid nodules in the larynx and epiglottis. In 1993, Hosako described a case of systemic lupus erythematosus (SLE) in which the submucosal lesions in the vocal folds did not resemble the rounded nodules. Instead, they had a stripe-like appearance perpendicular to the free vocal cord edge: “bamboo-joint like” [Hosako Y et al., Larynx Japan 1993; 6: 171–175]. Murano used the term “vocal fold bamboo nodes” to simplify the nomenclature of the same feature [Murano E et al., J Voice 2001; 15: 441–450]. Here, we present symptoms and clinical findings in a girl with bamboo nodes. In the literature, bamboo nodes are only reported in adults. Here we first describe a 13-year-old girl with bamboo nodes. To our knowledge, this is the youngest patient with a hoarseness and bamboo nodes ever reported; an associated autoimmune disorder has not been found so far.