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Inflammations of larynx.pptx
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- 2. LARYNGITIS Acute A) Acute nonspecific laryngitis -Acute laryngitis -Acute Epiglottitis -Acute laryngotracheobronchitis B) Acute specific laryngitis -Diphtheria -Herpes Simplex Chronic • A) Chronic nonspecific laryngitis -Simple diffuse chronic laryngitis -Chronic diffuse hyperplastic laryngitis (REINKE’s edema) -chronic localized hyprtrophic laryngitis -Keratosis/ leukoplakia -Contact ulcer B)Chronic specific laryngitis -Laryngoscleroma,T.B.,syphilis,leprosy,mycosis
- 3. ACUTE LARYNGITIS • Infectious/Non-infectious •Etio- -Non infectious -vocal abuse,allergy,burn,trauma -Infectious -Usually follow URTI caused by – virus (influenza,parainfluenza,rhino) later followed by bacteria such as-Strept. Pneum. ,H. influenza e.t. al
- 4. CLINICAL FEATURE • Hoarseness •Discomfort/Pain • Dry cough • General symptoms O/E—Erythema,edema,reddish,submucosal haemorrhages
- 5. TREATMENT Voice rest, Avoid smoking,Alcohol, Steaminhalation Cough sedatives Antibiotics Analgesics steroids
- 6. ACUTE EPIGLOTTITIS Causative org.-H. influenza type B More common in children
- 7. CLINICAL PICTURE • Startsby sore throat and followed by odynophagia and drooling • High fever 40 C • Associated features-malaise,headache,anorexia • Muffled voica AKA Hot potato voice • Rapidly progressive-stridor-life threatening
- 8. EXAMINATION • Marked edema, •Red swollen mass, • Pharyngeal congestion, • Uppper deep cervical L.N. enlargement • Xray- swollen epiglottis
- 9. TREATMENT • Hospitalization • IntubationVS Tracheostomy • Antibiotics • Steroids • O2
- 10. LARYNGOTRACHEOBRONCITIS • AKA croup •H. Streptococci (predominant)
- 11. CLINICAL PICTURE symptoms • Commoncold,mild fever, rhinorrhea, nasal obstruction • May be followed by toxemic features • Stridor (inspiratory) later biphasic • cough signs • Mucopurulent exudates • Subglottic edema
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- 13. TREATMENT • Hospitalization • Antibiotics •Steroids • Mucolytics • Croupette • ET VS TRACHE.
- 14. DIPTHERIA • Usually secondaryto Faucial diptheria • Specific features- Hoarseness,cough,stridor,dyspnea O/E- greyish white, dirty, diptheric membrane
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- 16. CHRONIC LARYNGITIS(NON SPECIFIC) •M/C in middle aged men • Predisposing factors- • Exogenous-recurrent acute laryngitis,smoking,chronic RTI,voice abuse,occupational • Endogenous-hypothyroidism, vit.A def.
- 17. CLINICAL PICTURE • Hoarseness •Worse in morning • +/- aphonia • Dry cough • pain
- 18. SIMPLE DIFFUSE CHRONICLARYNGITIS • Resembles acute laryngitis but prolonged • Treatment- • Avoid predisposing factors,voice rest,stem inh.,antibiotics
- 19. CHRONIC DIFFUSE HYPERPLASTIC LARYNGITIS/REINKE’S •Etio-same as above • Laryngoscopy- • Diffuse congestion of mucosa of larynx • Diffuse B/L symmetrical congestion • Edge of VC appear round not flat • Incomplete approximation during phonation
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- 21. CHRONIC LOCALIZED HPERTROPHIC LARYNGITIS •Vocal cord nodules(singer’s) • Localized area of hyperplasia of epithelium on free edge of VC or localized hematoma • Etio- • Abuse • GERD • Follow viral
- 22. CLINICAL PICTURE • Hoarseness •Weakness and change in timber of voice • Laryngoscopy- • B/L small tiny nodules, pinkish,free margin of VC • Site??
- 23. TREATMENT • Voice rest •Speech therapy • Topical steroid • MLS
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- 25. ETIO • Voice abuse-injuryto subepithelial connective tissue • Allergy Clinical picture— Hoarseness Aphonia aspiration
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- 28. • Hyperplasia andhyperkeratinization of epithelial lining
- 29. CONTACT ULCER AKAPACHYDERMA LARYNGIS
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- 31. T.B. • Secondary topulmonary tb • Chronic specific inflammatory granuloma caused by TB bacilli • Etio- • Incd-less than 2-5% of all cases of pulmonary TB • Organism??
- 32. PATHOLOGY • Site –posterior part • In order of frequency-(a) interarytenoid region (b) arytenoids (c) posterior part of vocal cord ,,may affect ventricular folds ,epiglottis (laryngeal Surface) • C/P and treatment
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- 35. • Age • Sex •Geography • Organism • Clinical picture- • Biphasic stridor, hoarseness of voice,cough
- 36. LARYNGOSCOPY • Subglottic region- •Pale,pinkish,smooth swelling on both side of subglottis with greenish crust • Subglottic web and stenosis • Lab investigation??? • Treatment???
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- 38. ETIO • Treponema pallidum-spirochate • Incidence-very rare • Mode of infection---acquired vs congenital • Site – anterior half of larynx, mainly epiglottis
- 39. CLINICAL PICTURE /TREATMENT General- skin rashes,veneral wart ,generalized lymphadenopathy Laryngeal- Hoarseness, stridor, cough Larynx—hperaemia of laryngeal mucosa,mucous patches, ULCER- punched out edges, yellowish necrotic floor,indurated base
- 40. LAB INVESTIGATIONS • Darkground microscopy- direct smear from syphilitic lesion which shows— spirochete • Serology— A)Non specific tests- wasserman rxn, VDRL B)Specific test –TPI(trapenoma pallidum immobilization test) -TPHA(T.P. haemagglutination test)
- 41. DL AND BX •Treatment— • Benzathine benzylpenicillin-100000 UI IM for—10-14 days • +/- tracheostomy
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