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1、HOARSENESS(ACUTE AND CHRONIC LARYNGITIS),Dr.ZAID AL-DAHWIConsultant ENT Head of ENT department KING SAUD MEDICAL CITY,ACUTE LARYNGITIS,DEFINITION It is the acute inflammation of larynx leading to oedema of laryngeal mucosa and underlying structures.,AETIOLOGY,INFECTIOUS:Viral Bacterial NON INFECTIOU
2、S Inhaled fumes Allergy Polluted atmospheric conditions Vocal abuse Iatrogenic trauma,Predisposing factors,SmokingPsychological strainPhysical stress,PAEDIATRIC CONCERNS,Lacks firm cartilaginous skeleton.Flabby,easily collapses.Glottic aperture,relatively smaller.Mucosa swells up rapidly in response
3、 to slightest trauma or infection.Stridor is the most noticeable presentation.,PATHOLOGY,The mucosa of the larynx becomes congested and may become oedematous.A fibrinous exudate may occur on the surface.Sometimes infection involves the perichondrium of laryngeal cartilages producing perichondritiis.
4、,CLINICAL PRESENTATION,Hoarseness or change in voice.Discomfort in throat,pain.Dysphagia,Dyspnoea.Dry irritating paroxysmal cough.Fever,Malaise.,CLINICAL DIAGNOSIS,Signs of acute URTI.Dry sticky secretions.Congested and swallon vocal cords.Diffuse congestion of laryngeal mucosa.,DIFFERENTIAL DIAGNOS
5、IS,Acute epiglottitisAcute laryngo tracheo bronchitis.Laryngeal perichondritisLaryngeal oedemaLaryngeal diphtheriaReinkes oedema,Chronic Laryngitis,Presents as diffuse lesion or produce localized effects in larynxChronic infectionsvocal abuse smoking,alcohal,irritant fumes.,Chronic Laryngitis,Histop
6、athologically there are mucosal thickining and infilteration of plasma cells and leukocytes.connective tissue elements are increased.,chronic laryngitis differential,Reinkes oedemavocal nodulesvocal cord polypContact ulcerHyperkeratosis and leukoplakiaAtrophic laryngitisLaryngeal lupustuberculous la
7、ryngitis,Vocal nodules,Nodular thickining of the free edge of vocal cordMore common in femalesUsually are bilateral,symmetrical occuring at the junction of anterior and middle thirdDevelop as hyperplastic thickining of epithelium because of vocal abuseFocal haemorrhage in subepithelial tissue,Vocal
8、cord polyp,Polypoidal lesion of cordsMore in malelocalised vascular engorgement and microhaemorrhage followed by oedema.Gelatinous,fibrous,talengiectatic,Tuberculous laryngitis,Almost always to secondary to pulmonary TBInfected sputumYounger age groupTubercle formation is characteristicInfilteration
9、 stage followed by proliferative stagePosterior part of larynx involved,Voice Therapy,Voice therapy is an approach to treating voice disorders that involves vocal and physical exercises coupled with behavioral changes.The purpose of voice therapy is to help attain the best possible voice and the mos
10、t relief from the vocal symptoms that are bothering the patient,To improve vocal hygiene,Drinking lot of fluids-Drink 7-9 glasses of water per day;also good are herbal tea and chicken soup.maintaining good general health-Exercise regularly.Avoiding smoking-They are bad for the heart,lungs and vocal tract.Eating a balanced diet-Include vegetables,fruits and whole grain foods.Avoid dry,artificial interior climates.Do not eat late at night-may have problems when stomach acid backs up on the vocal cords.Use a humidifier to assist with hydration.,THANKS,
