Hoarseness in tuberculosis

A study has been made of hoarseness in 26 tuberculous patients in Kandy (Sri Lanka). Tuberculous inflammation of the vocal cord or ventricular fold was its cause in 18 of them, in 17 of whom the laryngeal infection was due to direct implantation of tubercle bacilli from lung cavities through cough; in one it was probably haematogenous. Hoarseness in the other eight patients was due to recurrent laryngeal nerve palsy, the nerve being involved in tuberculous lesions, in six instances in the mediastinum and in three instances in the right apical pleura. However caused, hoarseness associated with active inflammatory disease cleared with anti-tuberculous chemotherapy, whereas that associated with fibrosis persisted.