Tuberculosis of the larynx

Area of Science:

• Otorhinolaryngology
• Infectious Diseases
• Pulmonology

Background:

• Tuberculosis of the larynx (TB) was historically common but is now rare due to anti-TB chemotherapy.
• Pre-antibiotic era recognized two infection routes: bronchogenic and hematogenous.

Observation:

• Reviewed 13 patients diagnosed with tuberculous laryngitis over 15 years at the University of Michigan.
• Bronchogenic infection was observed in 11 patients; hematogenous spread in 2.
• Histological examination revealed epithelioid tubercles in bronchogenic TB and acid-fast bacilli in hematogenous TB.

Findings:

• Bronchogenic TB was the predominant route of laryngeal infection in the observed cohort.
• Distinct histological findings differentiate bronchogenic from hematogenous laryngeal TB.
• Surgical intervention, including laryngofissure and grafting, successfully treated cicatricial laryngeal stenosis.

Implications:

• The subtle initial presentation of laryngeal TB necessitates its consideration in chronic laryngitis differential diagnoses.
• Understanding infection routes aids in diagnosing and managing rare cases of laryngeal TB.