Tubercular Laryngitis

  • Laryngeal tuberculosis is still relatively uncommon,approximately involved in 1-10% of all cases of tuberculosis
  • Affects posterior part more than the anterior part.
  • Almost always secondary to Pulmonary Tuberculosis.
  • Most commonly affected part is the interarytenoid fold.
  • Submucosal tubercles.
  • Pseudoedema (swollen laryngeal mucosa due to cellular infiltration).
  • Weakness of voice – earliest symptom.
  • Impairment of adduction – first sign
  • Mamillated appearance – swelling in the interarytenoid region
  • Mouse nibbled appearance – ulceration of vocal cord
  • Hyperaemia of the vocal cord in its whole extent or confined to posterior part with impairment of adduction is the first sign.
  • Superficial ragged ulceration on the arytenoids and interarytenoid region.
  • May cause Odynophagia.
  • Granulation tissue in interarytenoid region or vocal process of arytenoid.
  • Swelling of ventricular bands and aryepiglottic folds.
  • Marked pallor of surrounding mucosa.
  • Turban epiglottis – pseudoedema of glottis.
  • Does not cause paralysis of Vocal Cord.
Exam Question
  • Mammilated appearance , Mouse nibbled appearance,Turban epiglottis is seen in TB of larynx.
  • TB,Sarcoidosis,Syphilis may affect the Anterior Larynx.
  • Paralysis of Vocal cord does not occurs in TB Larynx.
  • TB Larynx may present with ulceration of Arytenoid and Odynophagia.
  • Tubercular laryngitis affects primarily Posterior commissure of larynx.

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