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Laryngeal tuberculosis.

Laryngeal tuberculosis is the most frequent granulomatous disease of the larynx. The disease has changed its behaviour with regard to average age of onset site and type of lesion. Laryngeal tuberculosis is usually secondary to, or at least contemporary with, pulmonary tuberculosis. Other recents studies, however, conclude by accepting a frequency of up to 20% for primary laryngeal tuberculosis. The age of presentation is between 41-50 years. Among the risk factors identified are the consumption of tobacco, alcohol, malnutrition and immunodeficiency. The predominant symptom was dysphonia (90%) either in isolation or accompanied by odynophagia (45%). Today, the ulcero-infiltrative lesions which predominantly affected the posterior larynx are not observed. At the present time the macroscopic appearance corresponds to a diffuse oedema or to a pseudo-tumoral image located in any zone. Any non-specific chronic laryngitis of poor evolution should lead us to suspect a laryngeal tuberculosis.

Adult↗

The changing pattern of laryngeal tuberculosis.

Laryngeal tuberculosis is now an uncommon disease in the United Kingdom. A series of ten cases is reported. In contrast to the pre-chemotherapy era, when the disease was associated with advanced cavitated pulmonary tuberculosis and was highly infectious, it now presents in a manner similar to laryngeal carcinoma except that painful dysphagia is a prominent symptom. All such patients should have a chest X-ray carried out as part of their initial investigation. Sputum is almost always positive for tubercle bacilli on direct films. Direct laryngoscopy and biopsy are necessary if a carcinoma is suspected. The change of pattern of the disease may be due to the fact that the larynx now usually becomes involved by haematogenous spread rather than by direct spread along the airways. Laryngeal tuberculosis is now no more infectious than pulmonary tuberculosis, and responds well to antituberculous chemotherapy. Symptoms resolve completely within three weeks if corticosteroids are given in combination.

Aged↗

The presentation of laryngeal tuberculosis.

Laryngeal tuberculosis is now a rare disease. We report 6 patients presenting within a 10-year period (1976-1986). Symptoms and signs often mimic carcinoma or chronic non-specific laryngitis. Greater clinical awareness and a chest radiograph prior to direct laryngoscopy may alert the clinician to the possibility of tuberculosis. The diagnosis is established by laryngeal biopsy.

Adolescent↗

Laryngeal tuberculosis following laryngeal carcinoma.

Laryngeal tuberculosis is a rare entity and the disease related to laryngeal cancer is extremely rare. We describe a case of laryngeal tuberculosis in a 74-year-old man with a history of radiotherapy for laryngeal carcinoma four months earlier. Laryngoscopy demonstrated a white mass on the right vocal fold at the site carcinoma had previously occupied. Recurrence of the cancer was suspected, but the biopsy result showed histological features of tuberculosis. We discuss the derangement of the host's mucosal barrier by the malignancy as a contributing factor in secondary tuberculous infection. Tubercular bacilli may be reactivated due to the immunosuppression associated with the therapy.

Aged↗

Laryngeal tuberculosis.

Laryngeal lesions observed in patients with pulmonary tuberculosis are most likely tuberculous. Although tuberculosis and carcinoma may be indistinguishable clinically and radiographically, specific radiographic studies better delineate the lesion and may suggest its true etiology. Five cases of laryngeal tuberculosis referred to M.D. Anderson Hospital and Tumor Institute as carcinoma of the larynx are described and illustrated. In the acute exudative type, inflammatory disease was suspected, but in the chronic localized lesion, carcinoma was the primary consideration. The histologic diagnosis was established by biopsy.

Adolescent↗

[Laryngeal tuberculosis and laryngeal cancer].

Account of 2 synchronic cases of tuberculosis and laryngeal carcinoma. Apart from bacteriostatic drugs one of them underwent a cordectomy the other one a total laryngectomy and neck dissection. Despite the great majority of laryngeal cancer it is compulsory to take in account the differential diagnosis with the tuberculosis, because of its possible coexistence. Perusal of national and international literature, having found only 11 of similar instances reported.

Carcinoma, Squamous Cell↗

CT findings of laryngeal tuberculosis: comparison to laryngeal carcinoma.

PURPOSE: Our goal was to describe the appearance of laryngeal tuberculosis using CT, with the intent of identifying features distinguishing laryngeal tuberculosis and carcinoma. METHOD: CT scans of 12 patients with laryngeal tuberculosis were analyzed retrospectively. Clinical symptoms, laryngoscopic exams, and presence of pulmonary tuberculosis on chest radiographs were also reviewed. RESULTS: In laryngeal tuberculosis, bilateral involvement was noted in nine patients (75%), while unilateral involvement was seen in three (25%). Diffuse thickening of the free margin of the epiglottis was a characteristic and frequent finding in tuberculosis (n = 6, 50%). No deep submucosal infiltration of the preepiglottic and paralaryngeal fat spaces was seen even when there was extensive involvement of the laryngeal mucosa. Cartilage destruction was not found in any case. CONCLUSION: Characteristic CT findings of laryngeal tuberculosis include bilateral involvement, thickening of the free margin of the epiglottis, and good preservation of the preepiglottic and paralaryngeal fat spaces even in the presence of extensive mucosal involvement. By comparison, laryngeal carcinoma presented unilateral involvement, infiltration of the preepiglottic and paralaryngeal fat spaces by a submucosal mass, cartilage destruction, and extralaryngeal invasion.

Adult↗

Laryngeal tuberculosis in childhood.

Laryngeal tuberculosis is an extremely rare condition in childhood, although probably less so in the underdeveloped world. We have described two cases treated concurrently in our wards. The first case showed features of a pharyngopalatotonsillar membrane, an exquisitely painful edematous pharynx and larynx and was initially sputum-negative for acid-fast bacilli. This presentation fits the hematogenous form of disease and stresses that: laryngeal tuberculosis is not confined to cases of far advanced pulmonary tuberculosis; tuberculosis should enter the differential diagnosis of pharyngeal, tonsillar and palatal lesions (especially membranoulcerative lesions); and there is a common association between laryngeal and abdominal tuberculosis. Her treatment included a 1-month course of steroids and to date (12 months after onset) she shows no signs of complications. The edematous form of laryngeal tuberculosis may be yet another indication for the use of steroids in tuberculosis. Our second patient presented with prolonged chest symptoms, initial positive sputum for acid-fast bacilli and localized granulomatous laryngeal disease, features of far advanced "adult" disease and bronchogenic laryngeal spread. Laryngeal tuberculosis usually responds rapidly to antituberculosis chemotherapy. This was clinically and endoscopically confirmed in both our cases.

Antitubercular Agents↗

[Laryngeal tuberculosis is not such a rare disease].

Laryngeal tuberculosis used to be the most common disease of the larynx at the beginning of the 20th century. As the incidence of tuberculosis decreased, laryngeal tuberculosis almost disappeared. The increase in the incidence of tuberculosis during the last two decades was accompanied by an increase in the incidence of laryngeal tuberculosis. Laryngeal tuberculosis is characterized by a wide variety of symptoms ranging from a process restricted only to the larynx, to a multiple system disease. The laryngeal findings are not specific and may imitate other chronic diseases and tumors of the larynx. This complexity encumbers diagnosis. In this study, we describe the changes in the population effected, the means of transmission and the appearance of laryngeal tuberculosis during the 20th century. We present the case histories of three patients exemplifying the existing variety in the clinical appearance of laryngeal tuberculosis.

Adult↗

Infectiousness of laryngeal tuberculosis.

Two patients with laryngeal tuberculosis in the absence of extensive pulmonary tuberculosis are presented. In both, tuberculin testing of household members failed to show infectiousness of their disease. This contradicts the commonly held view that laryngeal tuberculosis is invariably highly infectious. The extent and activity of pulmonary disease probably determines the infectiousness of patients with laryngeal tuberculosis rather than the laryngeal lesion per se.

Adult↗

[Laryngeal tuberculosis: a case report].

Laryngeal tuberculosis is considered by now a rare disease after the introduction and use of chemotherapeutic drugs the incidence of laryngeal tuberculosis an increase in the world population, including industrialized countries; this is partly due to the pandemy of the Acquired Immuno-Deficiency Syndrome (AIDS). The authors report a case of miliary laryngeal tuberculosis.

Humans↗

Current clinical propensity of laryngeal tuberculosis: review of 60 cases.

Although laryngeal tuberculosis is not frequent, it still occurs with an increasing incidence of pulmonary tuberculosis. Clinical pattern and spread mechanism of this disease have also changed as well. This study was performed to examine the current propensity seen in laryngeal tuberculosis and the clinical characteristics of this disease in patients showing atypical clinical pattern. The medical and videostroboscopic records of 60 patients with laryngeal tuberculosis diagnosed from the year 1994 to 2004 at the department of otorhinolaryngology in Severance Hospital were analyzed. The age of the patients ranged from 25 to 78 years, with their average age being 49.7 years. The ratio between men and women was 1.9:1. The major symptom encountered was hoarseness (96.6%). Clinically, granulomatous (n=22) and ulcerative types (n=11) of laryngeal tuberculosis were still prevalent, however, the incidence of atypical types such as polypoid (n=16) and nonspecific (n=11) were on the rise. Among the 27 cases that showed polypoid or nonspecific types, unilateral lesion was seen in 20 cases (74%). The most frequently affected area by this disease was true vocal cord, followed by false vocal cord, epiglottis, arytenoids and posterior commissure. Active pulmonary tuberculosis was present in 28 (46.7%), inactive pulmonary tuberculosis in 20 (33.3%), normal lung status in 12 cases (20%). Primary laryngeal tuberculosis was present in 9 cases (15%). Single lesion, polypoid and nonspecific type were prevalent in patients with inactive tuberculosis or normal lungs status. Physicians should be aware of the changes in the clinical pattern of laryngeal tuberculosis, which poses serious complications and risk of spreading.

Adult↗