title: [Secondary laryngeal tuberculosis at high altitudes of Tibet].
abstract: OBJECTIVE
  To improve the diagnostic and therapeutic efficiency for secondary laryngeal tuberculosis through an analysis on the clinical features of patients with this disease.
  
  
  METHODS
  A retrospective study was made among 49 cases with laryngeal tuberculosis treated in Tibetan General Hospital of Chinese PLA, and the clinical data were carefully analyzed to summarize the clinical experience of this disease.
  
  
  RESULTS
  Of 49 patients, 24 cases had 1 year history, 11 cases had 1 to 3 years, 9 cases had 3 to 5 years, 5 cases had 5 years or more. Thirty-eight patients had the history of tuberculosis and 11 had none. Thirty-four patients had taken anti-tuberculosis drugs but none had standard therapy as demanded. All cases had mild general symptoms (mild fever, night sweats, weight loss, et al) and atypical local symptoms (hoarseness, sore throat). Therefore, 42 cases were misdiagnosed as non-specific chronic laryngitis, of which 15 cases got worse after oral administration or inhaling of steroid hormones. Seven persons were misdiagnosed as laryngeal cancer. All patients were confirmed pulmonary tuberculosis by X ray exam or CT scanning. Twelve cases had strong positive PPD tests and 2 cases were detected positive by sputum smear. All patients was treated by standard systematic and local chemical therapy against tuberculosis (inhaling of antituberculosis drugs for 1 to 2 months). All were cured but one died in a road accident, and none had recurrence after 1- to 9- year follow-up.
  
  
  CONCLUSIONS
  All of those the patients with long period hoarseness and sore throat should take chest CT scan or X-ray exam for the highest incidence of pulmonary tuberculosis at high altitudes. CT scanning is the prefer for its high resolution. Pathological biopsy and diagnostic therapy should be taken to make accurate diagnosis. Usually steroid hormones should not be recommended.
authors.affiliation: Department of Otolaryngology-Head-and Neck Surgery, General Hospital of PLA, Beijing 100853, China. wht301@263.net
authors.forename: Hongtian
authors.initials: H
authors.lastname: Wang
authors.forename: Zongxi
authors.initials: Z
authors.lastname: Bai
authors.forename: Keqin
authors.initials: K
authors.lastname: Wang
authors.forename: Langjiebu
authors.initials: L
authors.lastname: Suo
authors.forename: Xingwen
authors.initials: X
authors.lastname: Liu
authors.forename: Yuebing
authors.initials: Y
authors.lastname: Ma
authors.forename: Chengpo
authors.initials: C
authors.lastname: Zhu
authors.forename: Yongsheng
authors.initials: Y
authors.lastname: Lin
authors.forename: Benwei
authors.initials: B
authors.lastname: Xie
authors.forename: Suzhi
authors.initials: S
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000531:Altitude; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018609:Tibet; D014387:Tuberculosis, Laryngeal / Q000175:diagnosis* / Q000188:drug therapy*; D055815:Young Adult