Laryngeal tuberculosis: A report of 17 cases.
OBJECTIVE
The aim of this study was to reduce misdiagnosis and inappropriate treatment of laryngeal tuberculosis.


METHODS
Between April 2009 and March 2013, 1660 inpatients with tuberculosis were treated at the Osaka Prefectural Medical Center for Respiratory and Allergic Diseases. Seventeen of these patients were diagnosed with laryngeal tuberculosis. Criteria used for diagnosis were findings of histologic examination of biopsy specimens (2 patients) or clinical response of granuloma to antituberculosis therapy (15 patients). Medical records were used for this retrospective study.


RESULTS
Patients' age ranged from 30 to 84 years with an average of 51.4±14.0 years (mean±SE); nine were men and eight were women. The most frequent chief complaint was hoarseness (n=15). Thirteen patients had persistent cough before they showed otolaryngologic symptoms. Endoscopic findings were categorized into five types of lesions: perichondritic (n=6), ulcerative (n=6), granulomatous (n=6), polypoid (n=1) and nonspecific inflammatory (n=1). Laryngeal tuberculosis showed as a single lesion in one patient and as multiple lesions in the other patients. The most commonly involved site was the true vocal cord (n=16, 94.1%), while 16 patients showed radiographic evidence of active pulmonary tuberculosis. These results indicate that deterioration of the lesions tended to result in the occurrence of multiple lesions.


CONCLUSIONS
While morbidity in tuberculosis has been decreasing in Japan, a significant number of patients still has laryngeal tuberculosis in association with advanced pulmonary tuberculosis. If a patient has a protracted cough, laryngeal tuberculosis should be taken into consideration for differential diagnosis. Pulmonary imaging study should be performed for early diagnosis and to prevent the infection from spreading.
Department of Otolaryngology, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan. Electronic address: masashikurokawa009@gmail.com.
Masashi
M
Kurokawa
Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Japan.
Ken-ichi
K
Nibu
Department of Otolaryngology, Ishibashi General Hospital, Japan.
Kei-ichi
K
Ichimura
Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, Japan.
Hiroshi
H
Nishino
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003371:Cough / Q000209:etiology; D005260:Female; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D007564:Japan; D007828:Laryngoscopy; D007830:Larynx / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014387:Tuberculosis, Laryngeal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D014827:Vocal Cords / Q000473:pathology*
D000995:Antitubercular Agents
Granulomatous lesions; Larynx; Perichondritic lesions; Polypoid lesions; Tuberculosis; Ulcerative lesions