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Sarcoidosis of the larynx: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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Detailed information about sarcoidosis as a benign granulomatosis (disease) of Besnier-Beck-Schaumann was given in the article " Sarcoidosis of the nose ". Here we will only recall that this disease develops at the level of the reticulohistiocytic system with a chronic course, characterized by the formation of specific granulomas in various organs and tissues.
Unlike tuberculous and syphilitic granulomas, sarcoidosis granulomas, like leprosy granulomas, do not undergo necrotic changes, but rather primary scarring, which distorts the structure of the affected organs and disrupts their functions.
[ What causes laryngeal sarcoidosis?
Laryngeal sarcoidosis develops for unknown reasons. According to modern concepts, sarcoidosis is a disease of impaired immunoreactivity with a special reaction of the body to the impact of various environmental factors.
Pathogenesis of laryngeal sarcoidosis
Sarcoidosis infiltrates arise in the reticuloendothelial tissues in the form of accumulations of epithelioid, sometimes giant cells, surrounded by lymphocytes. These infiltrates appear in the lymphoid apparatus of the respiratory tract, especially in the hilar lymph nodes of the lungs, as well as in the spleen, liver, pituitary gland, choroid, parotid and other glands, manifesting in other cases as Heerfordt's syndrome (subchronic febrile uveoparotitis: prolonged subfebrile body temperature, emaciation; nodular iridocyclitis develops; chronic parotitis; other salivary glands, mammary glands, testicles and ovaries are often affected; neurological symptoms of sarcoidosis of the larynx often occur, caused by damage to the cranial nerves, most often the facial, oculomotor and spinal nerves, the brainstem and signs of irritation of the meninges) or Mikulicz's syndrome - gradual painless generalized symmetrical swelling of the salivary and lacrimal glands; the mucous glands of the oral cavity, pharynx and larynx are often involved in the process; the disease lasts for years; late complications - enlarged lymph nodes, jaundice, enlarged liver and spleen. Sometimes phenomena of lacunar osteitis are observed in the bones of the skull, pelvis, sternum and nasal bones. According to statistics of the Romanian author N.Lazeanu et al. (1962), out of 59 patients with sarcoidosis of various localizations observed by them, 13 were found to have laryngeal lesions.
Symptoms of laryngeal sarcoidosis
The general condition with isolated laryngeal damage is practically not affected. Patients note such symptoms of laryngeal sarcoidosis as: some discomfort during phonation, more often than usual, a feeling of irritation, sometimes a transient sensation of a foreign body in the larynx.
The endoscopic picture of the larynx looks like polypoid formations covering the mucous membrane in the form of nodes or swellings with a smooth surface. These formations do not look like inflammatory infiltrates, are clearly separated from the surrounding mucous membrane of normal appearance, and are not subject to ulceration or necrosis. They are located mainly in the ventricles of the larynx or vocal folds. In other cases, these formations take the form of diffuse infiltrates, which are combined with similar formations in the nasal cavity, pharynx and on the skin. The disease progresses slowly, over many years, and is observed mainly in middle-aged people. Often, such people consult an ENT doctor, who treats them as patients with chronic hypertrophic laryngitis, not suspecting that they have sarcoidosis of the larynx. The general condition does not suffer.
Diagnosis of laryngeal sarcoidosis
Diagnosis of laryngeal sarcoidosis is difficult only in the case of isolated laryngeal lesions, which is observed very rarely. In the presence of lesions of the nasopharynx, lungs, skin, liver, etc., one should suspect the presence of laryngeal sarcoidosis, but the final diagnosis is established by histological examination.
Laryngeal sarcoidosis is differentiated from polyps, papillomas, tuberculosis, lupus, syphilis and malignant tumors of the larynx.
What do need to examine?
Treatment of laryngeal sarcoidosis
Treatment of laryngeal sarcoidosis is similar to that described in the article " Nasal sarcoidosis ". Infiltrates that cause disturbances of the phonatory and respiratory functions of the larynx are surgically removed from the endolaryngeal access under the "cover" of antibiotics and corticosteroids.