A Four Year Retrospective Study of the Pattern of Fungal Laryngitis in a Tertiary Voice Care Centre.

Abstract

Isolated Fungal Laryngitis (FL) has recently shown an increased incidence globally and is now being reported even in immunocompetent individuals. In our Voice Clinic we have documented an increasing number of cases of FL, specifically laryngeal candidiasis, with the lesion over the striking zone (anterior 1/3rd posterior-2/3rd) of vocal folds. Our objective was to study the sites of involvement of FL within the glottis along with a review of literature. A 4year retrospective study was performed by reviewing clinical and stroboscopic recordings of all patients diagnosed as FL at our Voice clinic. Age, gender, presenting complaints, co-morbidities, history of steroid intake orally or via inhalation and stroboscopic findings were noted as was response to antifungals and duration of treatment. A total of 55 cases were diagnosed with FL (all laryngeal candidiasis) between 2016 and 2019. Majority of them were immunocompetent, middle aged (41-60years) males. Hoarseness was the most common presenting complaint. On stroboscopy, the striking zone involvement was seen in 89.1% cases. On comparing site of involvement a chi-square value of 115.58; p <0.0001 was obtained. Complete resolution of the disease was observed after 3weeks of oral Fluconazole in 65.5% patients while 27.3% needed treatment for 6weeks and 7.2% did not improve necessitating excision of the lesion. Our study indicates the striking zone to be the most common site of involvement in patients with glottic FL. Statistical comparison between the sites of larynx affected revealed a p value< 0.0001.