No abstract available.
Tuberculosis, Laryngeal*

Tuberculous laryngitis was considered common during pre-antibiotic area but after the effective antitubercular medication, the incidence of laryngeal tuberculosis had decreased to less than one percent2. Clinical presentation is mostly unclear but usually presents with odynophagia, cough, hoarseness of voice and frequently confused with other diseases, more importantly fungal laryngitis. This is a case of a diagnostic dilemma of an immunocompetent 55-year-old male presenting with odynophagia, dysphagia and hoarseness of voice that was initially managed as a case of fungal laryngitis due to history of prolonged use of dexamethasone and findings of leukoplakia in laryngoscopy. Despite adequate time for treatment, no significant improvement was noted. Acid fast bacilli microscopy tested negative. A previous history of pulmonary tuberculosis treatment and chest radiographs revealing fibrosis on both upper lungs puts tuberculous laryngitis as one of the differentials. Sputum GeneXpert/RIF taken and tested positive, hence lead to the diagnosis of tuberculous laryngitis. Guideline-based quadruple anti-tubercular therapy started and had showed a positive response. Laryngeal tuberculosis (LTB) requires a high index of suspicion since it mimics various laryngeal diseases such as fungal laryngitis or malignancy. Clinicians should always be aware of the atypical clinical features of laryngeal tuberculosis and the possibility of primary laryngeal tuberculosis, for early diagnosis and prompt treatment, thus preventing morbid complications. A positive mycobacterial culture along with a typical histopathological appearance remain the cornerstone of diagnosis, but sputum AFB in microscopy and GeneXpert/RIF must not be ignored as these can be cost-effective diagnostic alternatives.
Tuberculosis, Laryngeal

Humans ; Tuberculosis, Laryngeal

No abstract available.
Carcinoma, Squamous Cell* ; Tuberculosis, Laryngeal*

Diagnostic Errors ; Humans ; Larynx ; Tuberculosis, Laryngeal ; diagnosis

PURPOSE: To determine the value of CT(Computerized Tomography) in the diagnosis of laryngeal tuberculosis and to assess to what extent its characteristic findings different from those of aryngeal carcinoma. Materials and Methods : CT scans of twelve patients with laryngeal tuberculosis were reviewed and compared with those of fifteen patients with laryngeal cancer, retrospectively. Clinical symptoms, laryngoscopic examinations and the presence of pulmonary tuberculosis on chest radiographs were also reviewed. RESULTS: In laryngeal tuberculosis, bilater alsymmetric or asymmetric involvement was noted in nine(75%) patients, while unilateral involvement was seen in three(25%). This was significantly different from laryngeal cancer in which unilateral involvement was noted in twelve patients(80%). Diffuse thickening of the free margin of the epiglottis was a characteristic and frquent finding in tuberculosis(n=6, 50%). No deep submucosal infiltration of preepiglottic and paralaryngeal fat spacesis seen in tuberculosis in spite of large areas of involvement of laryngeal mucosa, while twelve patients(80%) with laryngeal cancer showed thickened deep infiltration which resulted in a submucosal mass. CONCLUSION: CT was useful in the diagnosis of laryngeal tuberculosis and its CT findings wee characterized by bilateral involvement, thickening of the free margin of the epiglottis and good preservation of preepiglottic and paralaryngeal fatspaces in spite of large areas of involvement.
Diagnosis ; Epiglottis ; Humans ; Laryngeal Mucosa ; Laryngeal Neoplasms ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Laryngeal*

Tuberculosis of the larynx and the tonsil were not relatively uncommon diseases in the past, but they have become rare disease with the advent of effective antituberculous chemotherapy. Especially cases secondary to tuberculosis elsewhere in the body are indeed uncommon. We have recently seen a case of tuberculosis of the larynx associated with that of the tonsil which is thought to have developed secondary to miliary tuberculosis.
Adult ; Case Report ; Female ; Human ; *Tonsil ; Tuberculosis, Laryngeal/diagnosis/*etiology ; Tuberculosis, Miliary/complications/diagnosis

BACKGROUND AND OBJECTIVES: Although laryngeal tuberculosis is not common, it still occurs with an increasing incidence of pulmonary tuberculosis. The 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. SUBJECTS AND METHOD: We retrospectively analyzed 60 cases of laryngeal tuberculosis diagnosed from 1994 to 2004 in the department of otorhinolaryngology at Severance Hospital by evaluating clinical and videostroboscopic records. RESULTS: 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 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 the prevalent characteristics found in patients with inactive tuberculosis or normal lung status. CONCLUSION: Physicians should be aware of changes in the clinical pattern of laryngeal tuberculosis, which pose serious complications and risk of spreading.
Epiglottis ; Female ; Hoarseness ; Humans ; Incidence ; Laryngeal Diseases ; Larynx ; Lung ; Male ; Otolaryngology ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Laryngeal* ; Tuberculosis, Pulmonary ; Ulcer ; Vocal Cords

Humans ; Laryngoscopy ; Larynx ; Magnetic Resonance Imaging ; Tomography Scanners, X-Ray Computed ; Tuberculosis, Laryngeal ; diagnosis

OBJECTIVE: To explore the clinical characteristic and diagnosis of modern laryngeal tuberculosis. METHOD: A retrospective research among 33 patients of laryngeal tuberculosis, with definitive pathological result, had been done in the laryngeal-endoscope room in our department. RESULT: The main symptoms of laryngeal tuberculosis are hoarseness and sore throat. Most of the patients did not accompany with pulmonary tuberculosis (TB) (63.6%). Few of them accompany with low-grade fever, night sweat and malnutrition (24.2%). There are three types in the laryngeal-endoscope vision: edema type, hyperplasia type and ulcer exudation type. The positive rates of PPD and phlegm bacteria examination are respectively 87.9% and 68.4%. There can be seen in the pathological slides the interstitial phagocytes and giant cell reaction. Granuloma consisting of epithelioid cell and Langhans' cells is coexistent with necrotic tissue. Cheese necrosis is the typical characteristic of the disease. CONCLUSION Severe local symptoms of laryngeal with slightly general symptoms are the clinical characteristics of modern laryngeal tuberculosis. The diagnosis of it depends mainly on the process of the disease, laryngeal-endoscope examination and PPD examination combined with phlegm bacteria examination. And the final diagnosis is based on the pathological biopsy and tubercular bacillus culturing.
Adult ; Aged ; Female ; Humans ; Laryngoscopy ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Laryngeal ; diagnosis