Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Int J Infect Dis. 2010 Mar;14(3):e230-5. doi: 10.1016/j.ijid.2009.05.002. Epub 2009 Aug 3.
This study was undertaken to evaluate the changing trends in the clinical features of laryngeal tuberculosis, with the goal of reducing misdiagnosis and incorrect treatment.
A retrospective clinical analysis compared the clinical patterns in five cases with pathologically confirmed laryngeal tuberculosis seen before 1990 with those of 14 cases of laryngeal tuberculosis seen after 1998.
The five patients seen before 1990 ranged in age from 19 to 41 years of age, with a mean of 32 years. The most frequent chief complaint was odynophagia accompanying system symptoms and pulmonary tuberculosis. The posterior part of the larynx was commonly involved and the lesions tended to be ulcerative and multiple. The 14 patients seen after 1998 were aged from 17 to 71 years with a mean age of 49.9 years. The most frequent chief complaint was hoarseness (71.4%). The most common lesion site was in the true vocal cords (57.2%). Most of patients with normal lung status had single, nonspecific, polypoid lesions. Stroboscopy revealed four different appearances.
Laryngeal tuberculosis may occur even without pulmonary tuberculosis, and the characteristics of the lesions appear to be more nonspecific. It is important to consider tuberculosis in the differential diagnosis of laryngeal disease.
本研究旨在评估喉结核临床特征的变化趋势，以减少误诊和误治。
回顾性临床分析比较了 1990 年以前经病理证实的 5 例喉结核患者与 1998 年以后的 14 例喉结核患者的临床模式。
1990 年以前就诊的 5 例患者年龄 19～41 岁，平均 32 岁。最常见的主诉是伴有全身症状和肺结核的咽痛。喉后部受累常见，病变多为溃疡性和多发性。1998 年以后就诊的 14 例患者年龄 17～71 岁，平均 49.9 岁。最常见的主诉是声音嘶哑（71.4%）。最常见的病变部位是真声带（57.2%）。大多数肺部正常的患者均为单发、非特异性、息肉样病变。频闪喉镜显示 4 种不同的表现。
喉结核即使无肺结核也可能发生，病变特征似乎更不具特异性。在喉疾病的鉴别诊断中，应考虑结核。
