Benedict M, Schultz-Coulon H J
Universitäts-HNO-Klinik, Freiburg.
HNO. 1992 Dec;40(12):489-91.
We report the medical history of a 19 year old female patient with isolated laryngeal sarcoidosis, who was followed for 12 years. It illustrates the typical course of the disease with remissions and relapses until the inflammation is "burnt out." Although the laryngoscopic findings of pale-red swollen supraglottic structures are pathognomonic, diagnosis is rarely assumed at first sight. Long-term administration of cortisone in low dosage is the treatment of choice. Acute exacerbations with increasing airway obstruction may occur at any time, although in general a tracheotomy can be avoided because high-dose cortisone is highly effective. Over the years, the granulomatous character of the inflammation turns into a chronic non-specific one, while the laryngoscopic aspect hardly changed. Once the sarcoidosis is burnt out, the danger of an acute exacerbation diminishes.