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Inflammatory disorders of larynx [autosaved]
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Transcript of Inflammatory disorders of larynx [autosaved]
Inflammatory Disorders Of Larynx
Binaya BhandariRoll no. 4BDS,1st Batch,KUSMS ,Nepal
ClassificationAcute infections;- Acute simple laryngitis
- Acute epiglottitis- Viral LTB - Bacterial LTB
- Spasmodic croup
Chronic infections;-Chronic laryngitis
-Tuberculosis-Scleroma
-Candidiasis-Sarcoidosis
Laryngeal edemaLaryngo-Pharyngeal
Reflux Disease (LPRD)
Inflammatory Disorders Of Larynx
Acute LaryngitisDefinition; It is the acute inflammation of larynx leading
to oedema of laryngeal mucosa and underlying structures.
AetiologyInfectious; Viral – Influenza, Parainfluenza, Rhino virus Bacterial – H.influenzae, Strept. Pneumoniae, H.
Streptococci
Non Infectious; Inhaled fumes Allergy Polluted atmospheric conditions Vocal abuse Iatrogenic trauma
Inhaled Fumes Polluted atmospheric conditions
Vocal abuse Trauma
PathologyThe mucosa of the larynx becomes congested
and may become oedematous.A fibrinous exudate may occur on the
surface.Sometimes infection involves the
perichondrium of laryngeal cartilages producing perichondritiis.
Clinical FeaturesHoarseness which may lead to complete loss
of voiceDiscomfort or pain in throat, particularly
after talkingDry, irritating cough which is usually worse
at nightGeneral symptoms including headache, cold,
dryness of throat, malaise and fever if laryngitis has followed viral infection of upper respiratory tract.
Clinical DiagnosisSigns of acute URTI.Dry thick sticky secretions.Dusky red and swollen vocal cords.Diffuse congestion of laryngeal mucosa.
Differential DiagnosisAcute epiglottitisAcute laryngo tracheo bronchitis.Laryngeal perichondritisLaryngeal oedemaLaryngeal diphtheriaReinke’s oedema
TreatmentSupportive;
Voice rest.Steam inhalation.Cough suppressants.Avoid smoking and cold.Fluid intake.
Definitive; Antibiotics Steroids Analgesics
Chronic LaryngitisDefinition; It is a diffuse inflammatory condition
symmetrically involving the whole larynx, i.e. true cords, ventricular bands, interarytenoid region and root of epiglottis.
AetiologyIt may follow incompletely resolved acute simple
laryngitis or its recurrent attackPresence of Ch. Infections PNS, teeth, tonsils and
chest.Occupational factors – exposure to dust and fumes
such as in miners, strokers, gold, iron smiths and workers in chemical industries
Smoking and alcoholPersistent trauma of cough as in chronic lung
diseaseVocal abuse
Clinical FeaturesHoarseness. This is the commonest
complaint. Voice become easily tired and patient becomes aphonic by end of the day
Constant hawking. There is dryness and intermittent tickling in the throat and patient is compelled to clear the throat repeatedly
Discomfort in the throatCough. It is dry and irritating
Clinical DiagnosisDiagnosis is based upon a combination of the
clinical history and a physical exam. Some physicians might wish to do a laryngoscopy (visualization of the vocal cords).
Hyperemia of laryngeal structuresVocal cords appear dull red or roundedFlecks of viscid mucus are seen on the vocal
cords and interarytenoid region
Differential DiagnosisReinkes oedemaVocal nodulesVocal cord polypContact ulcerHyperkeratosis and leukoplakiaAtrophic laryngitisLaryngeal lupusTuberculous laryngitis
TreatmentEliminate URTI/LRTIAvoidance of irritating factorsVoice rest and speech therapySteam inhalationsExpectorantsAntibiotics
ReferencesDiseases of Ear, Nose and Throat – P L Dhingra ,
3rd editionAtlas of Acute and Chronic Laryngitiswww.healthline.comwww.patient.co.uk/health/www.myoclinic.orgwww.emedicine.medscape.comThank you
Any Queries ???