Leprosy of the larynx

Along with leprosy nose, leprosy of the larynx in endemic foci occurs quite often. As early as 1897, at the International Conference of Lepologists, general statistical data were given, according to which lesions of the larynx were observed in 64% of all cases of this disease (Gluck).

According to the observations of Romanian authors, out of 39 patients with leprosy of ENT organs only 3 had lepromatous nodes in the larynx, most of the remaining patients had only different forms of chronic nonspecific laryngitis. According to the world statistics, the larynx of the larynx in the overwhelming majority of cases is manifested in the lepromatous form and very rarely in the neurological form.

[1], [2], [3], [4], [5],

Pathogenesis of larynx of larynx

The solitary lepromatous infiltrates that arise in the larynx have no clear boundaries, in other cases these infiltrates have the character of a set of nodules possessing a granulomatous structure. Infiltrates consist of vacuolated cells, plasmocytes and histiocytes, have the ability to spread in breadth and depth, often infecting the cartilaginous tissue of the larynx. The causative agent of leprosy (Hensen's stick) is determined in large quantities in the form of sheaf-like agglomerations both inside the vacuolated cells and outside them. Infiltrates are disintegrated, causing extensive destruction of the larynx and leading to massive scars, disfiguring and stenotic larynx.

Symptoms of laryngeal larynx

In the initial stage, the larynx of the larynx manifests itself in the form of a short acute inflammatory reaction (hyperemia and swelling of the mucous membrane), which gradually turns into a chronic "dry" laryngitis, which can last for many years. A distinctive feature of this laryngitis is that when trying to treat it as an ordinary chronic atrophic laryngitis, instead of improving, the deterioration of the laryngeal mucosa and the activation of the lepromatous infection itself occur. However, most often short on the background of an atrophic mucous membrane, small nodular formations appear bluish or whitish-gray, which, merging, are transformed into nodular infiltrates, located mainly on the epiglottis and on the threshold of the larynx. Hence, lepromatous infiltrates extend to vocal folds and lining space. The edge of the epiglottis appears unevenly thickened, a nipple shape, which is given to it by nodular formations of different sizes - from millet pea. Sometimes these infiltrates acquire a papillomatous appearance.

The ventricles of the larynx are filled with diffuse infiltrates with an uneven surface of pale yellow color. Sometimes these infiltrates merge with the vocal folds, forming massive conglomerates, narrowing the breathing gap and posing a threat to the life of the patient. In the underlay space, which can be examined only with direct laryngoscopy, these infiltrates become circular, which aggravates the disturbance of the respiratory function of the larynx. Sometimes on the epiglottis, the arytenoid region and less frequently on the vocal folds ulcers are formed, which are the cause of the secondary perichondritis. All these changes tend to quickly heal, after which there are deep scars, disfiguring and stenosing larynx.

Lepromatous lesion of the larynx proceeds painlessly due to the property of the microorganism to release a special toxin that causes complete anesthesia (temperature, tactile and painful) of the affected tissue, which is observed not only with the nervous form of leprosy, but also with lepromatous form.

Phonon and respiratory disorders in leprotic larynx are permanent phenomena, the severity of which depends on the location and magnitude of infiltrates and the subsequent sclerosing process.

Diagnosis of laryngeal larynx

The diagnosis is established without special difficulties, since changes in the larynx occur later than cutaneous, nasal and pharyngeal manifestations of leprosy, when the diagnosis of this otolaryngological disease is already established.

[6], [7], [8], [9], [10], [11], [12]

Treatment of larynx of the larynx

If there is a violation of the respiratory function of the larynx, which threatens the patient's life, a tracheotomy is produced. As for the stenosis of the larynx, they will be discussed below, in the relevant section of this chapter.

What is the prognosis of leprosy of the larynx?

Leprosy of the larynx has a serious prognosis and largely depends on the general immunobiological state of the organism of the patient. With a good resistance of the patient or with the timely use of complex immunomodulatory treatment, a relatively benign form of leprosy develops - tuberculoid, which is well treatable. The prognosis for leprosy of the larynx is aggravated by the possibility of a critical disturbance of the respiratory function, the appearance of perichondritis and ulceration with attachment of the secondary infection and its spread to the perilaryngeal region and mediastinum with all the ensuing negative consequences.