Chronic Laryngitis - Lectures：慢性喉炎讲座.ppt

Chronic Laryngitis Prepared by Dr. Hiwa As’ad Definition: Is a chronic inflammation of the mucosa of the larynx. Etiology Follows repeated acute attacks but usually it arise insidiously due to : Faulty use of voice. Infection of teeth, tonsil, sinus, and lower respiratory tract infection. Excessive alcohol consumption or smoking. Dust or irritant fumes. Clinical classification: Chronic nonspecific laryngitis: Chronic simple laryngitis. Hyper keratosis of larynx (chronic keratosis or leukoplakia). Pachydermia laryngis. Contact granuloma. Atrophic laryngitis. Chronic specific laryngitis: Tuberculous laryngitis Syphilitic laryngitis. Leprosy of the larynx. Scleroma of the larynx. Wegener’s (malignant) granuloma of the larynx. Mycosis of the larynx. Chronic Nonspecific laryngitisSimple chronic laryngitis Pathology: Hyperaemia of vocal cord. Edema. Myositis occurs in the intrinsic muscles. Excessive secretion due to hyper activity of the mucous gland. Hyperaemic and edematous stage often passes to a hypertrophic one and rarely to an atrophic one. Clinical Features: -Hoarseness (intermittent then persistent). -Cough (slightly dry). -Sore throat (very common). Chronic laryngitis: there is hyperemia of mucus membrane. Odema of the margins of the vocal cord(Rienkes edema) Laryngeal appearance Three types: Hyperaemic. Hypertrophic. Edematous. In all types the larynx is always affected bilaterally symmetrically. Treatment: Vocal rest Elimination of irritating factors such as dust and smoking. Systemic antibiotics. Carbocisteine ( a mucolytic ) when secretion are thick. Stripping of the vocal cords is performed endoscopically in persistent cases. Chronic Nonspecific laryngitisHyperkeratois of the larynx (leukoplakia) Definition: A localized form of epithelial hyperplasia characterized by leukoplakic raised patches on the vocal cord. Pathology: There is hyperplastic change in the epithelium, together with extension of the papillae into the cornium; and basement mem