Sarcoidosis of the larynx: preserving and restoring airway and professional voice.
Professional voice users may present with disastrous dysponia and life-threatening upper airway disturbances due to a rare condition. Two teachers demonstrated extrathoracic obstructive laryngeal lesions by videolaryngoscopy and pulmonary function flow-volume loops. A characteristic "honking" voice and edematous, pink, diffuse turban-like enlargement of the supraglottic structures are considered pathognomonic of laryngeal sarcoidosis. Diagnosis was confirmed by biopsies, and clinical and radiologic findings. Sarcoidosis is a variable, disseminated disease involving many body organs, self-limited or progressive, with frequent exacerbations and remissions, affecting the larynx in 0.5-1.4% of patients. Spinal cord involvement demonstrated by new magnetic resonance imaging techniques can be heralded by voice changes detected in professional voice users. Systemic corticosteroid therapy combined with intralesional steroid injections and microendoscopic surgery, with or without tracheostomy, preserved and restored both professional voice and airway.
Gallivan
G J
GJ
Department of Surgery, Baystate Medical Center, Springfield, Massachusetts.
Landis
J N
JN
D000328:Adult; D000402:Airway Obstruction; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D007830:Larynx / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012507:Sarcoidosis / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D013116:Spinal Cord / Q000473:pathology; D013120:Spinal Cord Neoplasms / Q000473:pathology; D014139:Tracheostomy; D014832:Voice Disorders / Q000175:diagnosis; D014833:Voice Quality