Chronic Disorders of the Larynx

Chronic laryngitis More common in males than females, chronic laryngitis is aggravated by: 1 habitual shouting; 2 faulty voice production coupled with excessive vocal use. Seen in teachers, actors, singers; 3 smoking; 4 spirit drinking; 5 chronic upper airway infection, such as sinusitis. The voice is hoarse and fatigues easily.There may be discomfort and a tendency to clear the throat constantly. Examination shows the cords to be thickened and pink and the surrounding mucosa is often red and dry. TREATMENT Treatment is often ineffective. The voice should be rested as far as possible, any upper airway sepsis dealt with and steam inhalations given to humidify the larynx.Voice therapy may be helpful in cases of faulty voice production and referral to a singing teacher is of value to professional or amateur singers. Hyperkeratosis of the larynx Hyperkeratosis of the larynx may supervene upon chronic laryngitis. The cords become covered in white plaques of keratinized epithelium, which may become florid. Histology shows dysplasia, which may progress to malignancy, and the plaques should be removed for histology. Vocal cord nodules Vocal cord nodules (singer’s nodes) occur most commonly in children and result from excessive vocal use. The appearance is of a small, smooth nodule on the free edge of each cord, composed of fibrous tissue covered with epithelium. Removal by microlaryngoscopy followed by voice rest may be necessary but most cases respond to speech therapy. Tuberculosis of the larynx Tuberculosis of the larynx is now very rare and occurs only in the presence of pulmonary tuberculosis. Hoarseness occurs as a result of tuberculous granulations and agonizing dysphagia may follow.Treatment is by antituberculous drugs. Syphilitic laryngitis Syphilitic laryngitis is also extremely rare but the possibility of a gumma must be considered in cases of chronic hoarseness. Malignant change may also be present. NB. Any case of persistent hoarseness must be considered malignant until examination and, if necessary, biopsy have excluded such a cause.

Download Files

34-chronic-disorders-of-the-larynx.ppt (0.32 MB )