Nerurkar Nupur Kapoor
Bombay Hospital Voice and Swallowing Centre, Bombay Hospital & Medical Research Centre, 2nd Floor MRC, Mumbai, 400020 Maharashtra India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):904-909. doi: 10.1007/s12070-023-04316-w. Epub 2023 Oct 30.
Laryngeal tuberculosis (TB) is the commonest granulomatous condition found in the larynx and may be primary or secondary. With the recrudescence of tuberculosis and development of multidrug resistance, the classical disease trend of laryngeal tuberculosis is changing its manifestations. The aim of our study is to describe the various patterns of presentations of laryngeal tuberculosis in the current era and consequently its changing management protocols.
In this retrospective study, out of 890 patients who visited our voice and swallowing clinic in our study period, 10 were diagnosed as granulomatous conditions [1.1%] and 3 of these were confirmed cases of tuberculosis involving the larynx [0.3%]. Secondary laryngeal TB was found in 1 of our patients with a "dirty larynx picture". Primary laryngeal TB was seen in 2 patients, one patient presented with a unilateral congested vocal fold and the other with bilateral striking zone leukoplakia.
The clinical pattern of presentation of laryngeal tuberculosis has changed over the years. None of the patients of primary or secondary laryngeal tuberculosis had the classical constitutional symptoms of tuberculosis. In patients with laryngeal tuberculosis along with routine TB workup, surgical excision with histopathological testing is essential for accurate diagnosis in primary laryngeal TB and the "dirty larynx" picture aids in the diagnosis of secondary laryngeal TB. The healing and vocal outcomes are good in both primary and secondary laryngeal TB, once the appropriate antitubercular regimen has been started.
喉结核是喉部最常见的肉芽肿性疾病，可为原发性或继发性。随着结核病的复发和多重耐药性的出现，喉结核的经典疾病趋势正在改变其表现形式。我们研究的目的是描述当前时代喉结核的各种表现模式，以及相应变化的治疗方案。
在这项回顾性研究中，在我们研究期间到我们嗓音与吞咽门诊就诊的890例患者中，10例被诊断为肉芽肿性疾病[1.1%]，其中3例为确诊的喉部结核病例[0.3%]。在我们的1例患者中发现继发性喉结核，表现为“喉部病变”。原发性喉结核见于2例患者，1例表现为单侧声带充血，另1例表现为双侧显著区域白斑。
多年来喉结核的临床表现模式已经发生变化。原发性或继发性喉结核患者均无典型的结核病全身症状。对于喉结核患者，除常规结核病检查外，手术切除并进行组织病理学检查对于原发性喉结核的准确诊断至关重要，而“喉部病变”有助于继发性喉结核的诊断。一旦开始适当的抗结核治疗方案，原发性和继发性喉结核的愈合和嗓音结果都很好。
