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喉结核,大骗子:10 例系列。

Laryngeal tuberculosis, the great deceiver: A series of 10 cases.

机构信息

Department of Otorhinolaryngology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

Department of Otorhinolaryngology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

出版信息

Indian J Tuberc. 2024 Jul;71(3):238-241. doi: 10.1016/j.ijtb.2024.07.001. Epub 2024 Jul 14.

DOI:10.1016/j.ijtb.2024.07.001
PMID:39111930
Abstract

BACKGROUND

Laryngeal involvement is rare in tuberculosis, representing around 1% of all cases of this infection worldwide. Given the larynx' location in the airway, this form of tuberculosis is of particular importance because it is highly contagious. With our hospital being in a high tuberculosis burden area, we propose to characterize the clinical presentation, evolution, and laryngoscopy findings of a series of laryngeal tuberculosis cases in order to reduce misdiagnosis.

METHODS

Epidemiological and clinical data from 10 patients diagnosed with laryngeal tuberculosis in the Otorhinolaryngology department of (Blinded for manuscript) between January 2011 and December 2021 were retrieved and analyzed.

RESULTS

There were eight males and two females. Seven patients had a history of smoking and alcohol abuse and four had silicosis. Hoarseness was the most reported symptom (n = 9). The most frequent site of involvement were the true vocal cords (n = 6). All patients but one had concomitant active pulmonary tuberculosis. Patients had full resolution of laryngeal symptoms between 4 and 16 weeks after initiating antituberculosis treatment.

CONCLUSION

Laryngeal tuberculosis is indeed a great deceiver. On one hand it can look like a simple polypoid lesion or simulate laryngopharyngeal reflux; but on the other hand its risk factors, symptoms and appearance simulate laryngeal carcinoma like no other. Since most patients present with concomitant pulmonary tuberculosis, all suspect laryngeal lesions should perform a chest radiograph prior to rigid laryngoscopy. Antituberculosis treatment is effective in both alleviating symptoms and reducing the risk of transmission.

摘要

背景

喉结核较为少见,占全球结核感染病例的 1%左右。由于喉部位于呼吸道内,这种形式的结核具有特别重要的意义,因为它具有高度传染性。由于我们医院处于结核病高发地区,我们拟对一系列喉结核病例的临床表现、演变和喉镜检查结果进行特征描述,以减少误诊。

方法

检索并分析了 2011 年 1 月至 2021 年 12 月期间在(医院名称暂隐去)耳鼻喉科诊断为喉结核的 10 例患者的流行病学和临床数据。

结果

患者中男性 8 例,女性 2 例。7 例患者有吸烟和酗酒史,4 例有矽肺。声音嘶哑是最常见的症状(n=9)。最常受累的部位是真声带(n=6)。除 1 例患者外,所有患者均同时患有活动性肺结核。患者在开始抗结核治疗后 4 至 16 周内,喉症状完全缓解。

结论

喉结核确实是一种极具欺骗性的疾病。一方面,它可能看起来像一个简单的息肉样病变或模拟喉咽反流;但另一方面,其危险因素、症状和表现与喉癌非常相似。由于大多数患者同时患有肺结核,因此所有可疑的喉部病变在进行硬性喉镜检查前均应先进行胸部 X 光检查。抗结核治疗在缓解症状和降低传播风险方面均有效。

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