Laryngitis Lectures慢性喉炎讲座ppt课件.pptVIP

Chronic Laryngitis;Definition:;Etiology;Clinical classification:;Chronic Nonspecific laryngitisSimple chronic laryngitis;;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);Clinical features: Hoarseness ( gradual onset). Examination :there is a white raised patch on one or both vocal cords the anterior and middle thirds are usually involved. Mobility of cords is not impaired. Treatment: -Infection in the mouth, throat and nose treated. -Stripping of the cords can sometimes be done through a direct laryngoscope but recurrence is usual Constant supervision is essential to detect early malignant change demanding radical removal or radiotherapy. -Biopsy is mandatory in suspicious cases and may require repetition. ;;Chronic Nonspecific laryngitisPachydermia Laryngis:;Pathology: Hypertrophy occur both in the epithelium and subepithelial connective tissue. An inflammatory reaction may be seen. Neoplastic changes does not occur. Clinical features: Hoarseness Sore throat Granular or papilliferous appearance which occur in the posterior sites and is bilateral and symmetrical;Treatment: Similar to that for simple chronic laryngitis. surgical removal and diathermy of the masses give little relief and are inadvisable.;Chronic Nonspecific laryngitisContact Granuloma:;;Chronic Nonspecific laryngitisAtrophic Laryngitis:;Treatment : Treatment of infection any where Change of atmospheric conditions Removal of crust will give some local relief. This is aided by: Inhalation of menthol Carbocisteine by mouth. Hormones (results are uncertain) Laryngeal spray e.g.