Chronic Hypertrophic Laryngitis Research Articles

Нейродистрофии как дополнительный критерий в классификации дисфоний

Introduction. Based on the fact that all classifications are a method of generalization, most authors in their own research, as a rule, use several classifications. On the one hand, this allows obtaining the most accurate characterization of the disease and substantiating the methods of its treatment. On the other hand, it significantly reduces the possibility of comparing various data and an adequate assessment of the etiological and pathogenetic mechanisms of the disease. The results of a long-term study of laryngeal diseases, considering one of the main etiological and pathogenetic causes, which is a violation of the adaptive-trophic function of the autonomic nervous system (ANS), allow, to some extent, eliminating the existing difficulties. Objective. Transformation of the classification systematics of dysphonia considering the neurogenic link of pathogenesis. Materials and methods. A comprehensive clinical and physiological examination of 125 patients aged 18 to 75 years was carried out for voice disorders with clinical diagnoses of “polyp of the vocal fold” (60), “chronic laryngitis” (20), “hypotonic type of functional dysphonia in combination with laryngeal hypersensitivity” (45). During the examination, the medical history was studied, an objective examination of the upper respiratory tract according to generally accepted methods and with the help of videostroboscopic unit, cytological examination of impression smears from the affected laryngeal area, and a study of the functional state of the ANS as well as the surgical material, including histological and histochemical examination of the removed tissue, were carried out. Surgical intervention to remove pathological formations was performed in 60 cases in patients with polyps of the vocal folds and in 3 cases in patients with chronic laryngitis. Results. The conducted studies have shown that the changes that lead to chronic hypertrophic laryngitis, functional dysphonia, tumor-like hyperplastic-dystrophic processes as well as the changes in the sensitivity of the larynx by the type of «denervation hypersensitivity» are largely associated with neurogenic, including neurodystrophic, pathogenicity factors. In groups of patients with inadequate autonomic maintenance of activity, where it is a question of violations of the functional activity of the ANS (insufficient or excessive autonomic maintenance of activity), pathological dystrophic changes of varying severity develop in the mucous membrane of the larynx. Conclusion. The proposed classification of dysphonia is based on the clinical and morphological features of laryngeal diseases, including the neurodystrophic component of the development of the pathological process.

The role of autonomic nervous system imbalance in the pathogenesis of hyperplastic laryngitis

A decrease in the mediator activity of nerve structures in organ tissues leads to the development of neurodystrophic changes and an increase in their sensitivity to certain influences. In these planets, it is important to assess the morphological characteristics of target structures, taking into account the neurodystrophic component of the disease. The aim of the study was to determine the activity of the peripheral adrenergic link of the trophic reflex and assessing the morphological features of the mucous membrane of the vocal folds in chronic hypertrophic laryngitis in patients with neurovegetative disorders. Materials and methods: the study involved 45 patients (37 men and 8 women) aged 23 to 72 years with a diagnosis of chronic hypertrophic laryngitis. An objective study of the upper respiratory tract, a cytological study of reprinted smears from the affected areas of the larynx, a study of the functional state of the ANS, as well as a histological and histochemical study of the removed tissue were carried out. Results. The examined patients were found to have dysfunction of the ANS in the form of insufficient or excessive autonomic support of activity. Morphological signs of keratinization of the epithelium of the mucous membrane of the vocal folds and its active proliferation, as well as dystrophic and atypical changes in cellular elements revealed as a sign of insufficient, tact and a sign of excessive vegetative support of activity. It was found that with insufficient vegetative support of activity, the proliferative activity of epithelial cells is more pronounced than that of a chemer with excess. The same applies to keratosis with atypia and dystrophic changes in the epithelium. Conclusions. The activity of the interstitial adrenergic nerve structures of the mucous membrane of the vocal folds correlates with the characteristics of autonomic activity. The weakening of the processes of synthesis, accumulation and excretion of neurotransmitter is associated with insufficient vegetative support of activity, and their strengthening is associated with excessive. The amount of neurotransmitter in peripheral nerve fibers and endings depends on the nature and intensity of manifestations of neurogenic dystrophies developing in executive tissues – targets of adrenergic innervation.

The smoker’s larynx: a histopathological study

<p class="abstract"><strong>Background:</strong> Larynx of chronic smokers was clinically evaluated under high powered magnification as well as on histopathology to study the effect of fumes of nicotine on the vocal cords.</p><p class="abstract"><strong>Methods:</strong> 32 chronic smokers undergoing Lewis suspension micro laryngeal surgery were selected from the laryngology clinics of Dayanand Medical College and Hospital, Ludhiana. Intraoperative findings were recorded and the specimens were sent for histopathological examination. The study was undertaken in a period of one and a half years (June 2009-December 2010). </p><p class="abstract"><strong>Results:</strong> Maximum patients 31% (10 patients) underwent microlaryngeal surgery were smokers in the middle age group (40-50 years) and minimum 9.3% (3 patients) were above 60 years of age. Vocal polyp/polypoidal change was seen in 7 (21.87%) patients was the predominant finding followed by a chronic hypertrophic change 5 (15.62%) patients. leucoplakia 4 (12.5%) cases, tubercular caseation 3 (9.3%), vocal nodules 4 (12.5%) and vocal cysts 1 (3.125%) were the other findings in our series.</p><p class="abstract"><strong>Conclusions:</strong> Nicotine fumes affect the epithelium of the vocal cord leading to hypertrophic or hyperplastic transition. Vocal cord polypoidal change, squamous cell carcinoma and chronic hypertrophic laryngitis, in that order were the lesion in our series.</p>

Extramedullary plasmacytoma of the larynx manifesting as chronic hypertrophic laryngitis

Extramedullary plasmacytoma of the larynx manifesting as chronic hypertrophic laryngitis

Prevention of occupational laryngitis in teachers

The number of people in need of phoniatric help is constantly increasing. People with voice problems are of working age. The object of researche: lowering risk of progression of vocal pathology based on a comprehensive system of management of teachers’ occupational risks. Hygienic, epidemiological, sanitary-statistical, in-depth medical examination method and mathematical-statistical methods were applied. Working conditions of teachers are characterized by complex effects of harmful production factors, which can reach 3d degree of 3d class of harmful work by intensity (according to the calculated points 3,63), 2nd degree of 3d class of harmful pressure on vocal apparatus (27,52±3,54 hours), 1st degree of 3d class of harmful by equivalent noise level and unfavorable microclimate. The most widespread pathologies of the vocal apparatus are chronic hypertrophic laryngitis (190,20±22,61) and chronic catarrhal laryngitis (131,00±15,07 cases). Almost 70% of occupational laryngitis cases are in the age group of 46-60 years. The critical length of service influenced by voice load is 10-19 years. The length of service more than 20 years in conditions of voice load increases the etiological percent of occupational pathology causes to 81,8%. Therefore, an age of 45,8±0,5 and older is dangerous for the occupational laryngitis progression and requires a special approach of development and imple­mentation of preventive measures aimed at maintaining of occupational health. Suggested complex of measures increase the healthy life by 7,3 years and reduce the loss of healthy life years determined by the impact of voice activity by 7,1 years. At the same time for physical health component (PH) by 4,5 and 4,3, and the psychological health component (MH) by 10,3 and 10,1 years QALY respectively.

Value analysis of Danqing SanjiaSan in the treatment of chronic hypertrophic laryngitis during the implementation of auxiliary atomization inhalation nursing

Objective To analyze the value of Danqing SanjiaSan in the treatment of chronic hypertrophic laryngitis during the implementation of auxiliary atomization inhalation nursing. Methods A total of 57 cases of patients with chronic hypertrophic laryngitis treated with Danqing SanjiaSan, who were admitted to the hospital from April 2016 to April 2018, were selected as the study subjects, and were divided into the observation group with 28 cases and the control group with 29 cases according to simple random sampling.The control group was treated with oxygen-driven budesonide nursing intervention, and the observation group was treated with laryngning atomizer spray throat on the basis of routine intervention.Blood oxygen saturation, clinical efficiency, TCM syndrome score, voice acoustic time and hospital stay were compared between the two groups. Results There was no significant difference between the two groups of patients in blood oxygen saturation before assisted atomization nursing(P>0.05). After nursing intervention, the blood oxygen saturation of patients in both groups was improved, but the value of blood oxygen saturation in the observation group was higher than that in the control group, and the difference between the two groups was statistically significant(P 0.05). After intervention, the sound time of the two groups was prolonged, but the sound of the observation group was longer than that of the control group, the difference was statistically significant(P<0.05). Conclusions Budesonide combined with lanning atomizing agent can optimize the clinical rehabilitation effect of patients with chronic hypertrophic laryngitis treated with conventional therapy combined with Danqing SanjiaSan. Key words: Danqing SanjiaSan; Chronic hypertrophic laryngitis; Atomization inhalation; Budesonide; Aerosol inhalation of larynx

Laryngeal sarcoidoisis – a case report

Introduction. Sarcoidosis is a multi-organ disease characterized by noncaseating granulomas. The lesions are usually localized within the lungs and hilar lymph nodes. The sarcoidosis of the upper respiratory tract (SURT) rate is estimated at 0.5-6%. The involvement of the larynx is extremely rare - it occurs in 1.2% of cases of SURT. Materials and methods. We present a case of a patient with laryngeal sarcoidosis. Results. A 48-year-old man had had a diagnosed of dysphonia for 5 years. A diagnosis of chronic hypertrophic laryngitis was made. Empirical course of methylprednisolone was attempted with a short-term improvement. Due to coexisting skin lesions, he was diagnosed with allergy. Chest CT showed moderately enlarged mediastinal and hilar lymph nodes as well as bilateral nodules around the hila. The bronchial biopsy showed no granulomas. Samples taken during microlaryngoscopy revealed sarcoid infiltrates. Conclusions and discussion. There is no unambiguous test confirming the diagnosis of sarcoidosis. It is a typical example of a diagnosis by exclusion. Laryngeal involvement is extremely rare and occurs in 1.2% of cases of SURT. The clinical course of the disease is often difficult to predict. In many patients, the lesion may undergo spontaneous regression. In patients poorly responding to steroid therapy or developing side effects, cytotoxic drugs may be considered.

Современный подход к диагностике хронического ларингита

The timely detection and treatment of chronic hypertrophic laryngitis is a task of particular importance, it is the main link in the prevention of malignant diseases of the larynx. The traditional diagnostic methods do not always provide proper assessment of the state of the larynx in chronic laryngitis and the dynamics of recovery processes during therapeutic activities. Therefore, the combined use of modern methods of examination of the larynx condition is getting more and more important. Based on examination of 15 men and 5 women aged from 24 to 72 years previously treated for chronic hypertrophic laryngitis, it has been shown that video stroboscopy, autofluorescence diagnostics, NBI endoscopy, and cytological examination of swabs from the affected vocal fold areas are methods of early diagnostics of chronic hyperplastic laryngitis, they can complement each other not only in the event of diagnostic difficulties, but in the assessment of efficacy of treatment and rehabilitation measures aimed at restoration of laryngeal functions and prevention of the development of tumors. The data obtained made it possible to clarify the nature of the hypertrophic changes in the mucous membrane of the vocal folds and thereby confidently interpret the clinical picture of the disease in the examined patients as a manifestation of chronic hyperplastic laryngitis with leukokeratosis and leukoplakia.

High energy techniques in surgical treatment of reinke’s edema (data analyses and our experience)

Reinke’s edema is a form of chronic hypertrophic laryngitis. Conservative treatment includes IPP in case of concomitant refux esophagitis, phonopedic and anti-inflammatory local treatment. It’s strongly recommended to give up smoking to all patients. Unseccessful conservative therapy, laryngeal stenosis and severe hoarseness are indications for surgical treatment. In ENT Department of IM Sechenov First Moscow State Medical University 10 adult patients (female) with Reike’s edema were treated. In 7 patients surgery performed by K.Storz «cold-steel» instruments, in other 3 cases semiconductor laser was used. Results assessed by laryngostroboscopy and acoustic voice analyses data. Patients were observed upon 1 month after surgery. In «laser» group of patients shorter rehabilitation time has been noticed.

Reinke’s oedema of vocal cords’- Anaesthetic Considerations

Reinke’s oedema (RE) also known as polypoid corditis, laryngitis or chronic hypertrophic laryngitis is associated with chronic accumulation of fluid in the sub epithelial compartment of the vocal fold. 1,2 It can cause airway problems in patients with undiagnosed RE, but can also cause difficult intubation in patients already diagnosed with RE due to diffuse swelling of vocal cords. We hereby report a case of 55 year old female with RE admitted for decortication of vocal folds and discuss the anaesthetic implications

Zastosowanie wideolaryngostroboskopii w diagnostyce oraz ocenie wyników leczenia u chorych ze zmianami organicznymi krtani

The aim of the work was to evaluate effects of the surgical treatment and postoperative rehabilitation of the patients with organic lesions of the larynx using laryngostroboscopy. A group of 110 patients of both sex was covered by the studies, aged 19-65, who underwent surgical treatment due to organic lesion in the larynx. The voice was assessed using the perceptive GRBAS scale and the laryngostroboscopic examination following and preceding the surgical treatment and foniatric rehabilitation (30 days after the operation). Direct microlaryngoscopic procedures were performed under local intratracheal anaesthesia, whereas the CO2 laser was used in the surgery in 18.2% cases and the other cases (81.8%) had the traditional technique applied. RESULTS OF THE STUDIES: In the studied material the following was found: chronic hypertrophic laryngitis in 46.4% of the patients, Reincke's laryngeal oedema in 29.1% of the patients, vocal cord polyp in 22.7% of the patients and laryngeal papilloma in 1.8% of the patients. The voice evaluation based on the GRBAS scale indicated that better voice improvement after the treatment and rehabilitation was found in the patients with Reincke's oedema and vocal fold polyp rather than in those with chronic laryngeal hypertrophy. The majority showed the degree of hoarseness, rough voice, blowing voice, weak and tight voice in the scale of either 0 or 1, contrary to the evaluation preceding the surgery. No better voice improvement was achieved in the GRBAS scale in the patients with laryngeal papilloma. On the grounds of the laryngostroboscopic examination it was found that the best voice improvement occurred after the surgical treatment and rehabilitation of the patients suffering from Reincke's oedema and vocal cord polyps. On the basis of the GRBAS scale and laryngostroboscopic examination of the patients after their surgical treatment and rehabilitation the best results in the voice quality were found in the patients with laryngeal polyps and Reincke's oedema whereas the worst results occurred in the patients with laryngeal papilloma.

Ocena wyników leczenia przewlekłych przerostowych zapaleń krtani na podstawie badania wideolaryngostroboskopowego

This work aimed at assessing effects of surgical treatment and post-operative rehabilitation of chronic hyper trophic laryngitis by videolaryngostroboscopy and the GRBAS scale. The examinations were carrie on 50 patients of both sex, including 16 women (32.0%) and 34 men (68.0%) at the age of 19-66, surgically treated due t oedema hypertrophic lesions in the larynx. The voice was assessed by the perceptive GRBAS scale, a subjective voice self-assessment questionnaire, and through pre- and post-therapy videolaryngostroboscopic tests, which were also conducted afte phoniatric rehabilitation (30 days after the operation). Physical therapy (iontotherapy with hydrocortisone and 1% solutio of CaCl2) and respiratory and phonatory exercises were introduced in the rehabilitation. The GRBAS scale indicate that the patients with the Reincke's oedema and vocal fold polyp showed greater voice improvement after the therapy an rehabilitation than those with chronic hypertrophic laryngitis. Contrary to the assessment carried out before the surgica procedure, the hoarseness level, rough voice, breathing voice, weak voice and tense voice mainly ranged between 0 and scale. In stroboscopy a correct marginal shift and occlusion of the glottis were noticed in each case after eliminating lesion like Reincke's oedema and vocal fold polyp (merely in 6.0% we found a disorder in the marginal shift). In the above patient their voice formation was unrestrained, 69.0% and 75.0% respectively, mid-location of the voice was normal in 92.0% an 88.0%, normal phonation time in 85.0% and 94.0%, and accurate voice setting in 77.0% and 75.0%. In stroboscopy the wors results of the voice assessment were obtained in the laryngeal papilloma patient. The videolaryngostroboscop seems a perfect diagnostic method in larynx diseases, both in qualifying patients for a surgical treatment and monitorin effects of the treatment and post-operative rehabilitation.

咽喉頭異常感症と胃食道逆流症の関連性―Ｆスケール問診票による検討―

To evaluate the role of gastroesophageal reflux disease (GERD) in patients with globus pharyngeus, we performed a study with a simplified questionnaire for evaluation of GERD, e. g. a frequency scale for symptoms of GERD (FSSG).Patients experiencing a lump in the throat without local pathological findings and those with chronic hypertrophic laryngitis showed significantly higher FSSG score than those with other ear, nose or throat disorders. The response rate to anti-acid treatments (H2 receptor blockade or proton pump inhibitor) were 28.6% in patients with FSSG scores below 7 points (n=14), 56.5% in those with scores between 8 and 14 points (n=23), and 85.7% in those with scores above 15 points (n=21). After treatments, FSSG score significantly decreased in responders (n=34, 16.8±1.00 vs 7.15±0.668, p<0.0001), but not in non-responders (n=12, 12.6±1.65 vs 11.3±1.71, ns).

TREATMENT OF CHRONIC HYPERTROPHIC LARYNGITIS

Chronic hypertrophic laryngitis occurs often as a result of abuse or misuse of the larynx. Constant trauma, especially in the presence of infection, produces permanent changes in the tissues. The result of this process may take the form of a localized area of inflammation or involvement of the entire membranous cord. In 1934, Lore 1 called attention to the latter type of hypertrophic laryngitis. In addition to observations made in experimental work on animals, he recorded the results obtained in 4 patients by stripping off the mucous membrane of the hypertrophic vocal cord. The etiologic factor would seem to be trauma to the cords by habitual misuse of the larynx, by repeated acute infection or by a combination of these. In our series of 8 cases one or both of these conditions were present. Three patients worked in a noisy environment in which it was necessary for them to shout in

Chronic Hypertrophic Laryngitis Treated by Diathermy

Chronic Hypertrophic Laryngitis Treated by Diathermy

Chronic Hypertrophic Laryngitis Treated by Diathermy (Previously Shown April 8, 1927)

Chronic Hypertrophic Laryngitis Treated by Diathermy (Previously Shown April 8, 1927)

Chronic Hypertrophic Laryngitis, Treated by Diathermy

Chronic Hypertrophic Laryngitis, Treated by Diathermy

An Epidiascopic Demonstration of Chronic Hypertrophic Laryngitis, with Some Observations on the Treatment

An Epidiascopic Demonstration of Chronic Hypertrophic Laryngitis, with Some Observations on the Treatment

Notes of two Cases in which Chronic Hypertrophic Laryngitis preceded Papillomata.—Cure of One Case by Endolaryngeal Operation

Notes of two Cases in which Chronic Hypertrophic Laryngitis preceded Papillomata.—Cure of One Case by Endolaryngeal Operation