title: Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis.
abstract: BACKGROUND
  Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking.
  
  
  OBJECTIVE
  To identify factors associated with clinical and topographical features of LTB.
  
  
  METHODS
  a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis.
  
  
  RESULTS
  Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones.
  
  
  CONCLUSIONS
  Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement.
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.|Laboratory of Immunoparasitology, Oswaldo Cruz Institute (IOC), FIOCRUZ, Rio de Janeiro, RJ, Brazil.|Department of Bronchoesophagolaryngology and Head and Neck Surgery, Bonsucesso Federal Hospital, Rio de Janeiro, RJ, Brazil.
authors.forename: João Gustavo Corrêa
authors.initials: JG
authors.lastname: Reis
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
authors.forename: Clarissa Souza Mota
authors.initials: CS
authors.lastname: Reis
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.|Laboratory of Immunoparasitology, Oswaldo Cruz Institute (IOC), FIOCRUZ, Rio de Janeiro, RJ, Brazil.
authors.forename: Daniel César Silva
authors.initials: DC
authors.lastname: da Costa
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.|Department of Otorhinolaryngology and Ophthalmology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Márcia Mendonça
authors.initials: MM
authors.lastname: Lucena
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
authors.forename: Armando de Oliveira
authors.initials: Ade O
authors.lastname: Schubach
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
authors.forename: Raquel de Vasconcellos Carvalhaes
authors.initials: Rde V
authors.lastname: Oliveira
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
authors.forename: Valéria Cavalcanti
authors.initials: VC
authors.lastname: Rolla
authors.affiliation: Laboratory of Immunoparasitology, Oswaldo Cruz Institute (IOC), FIOCRUZ, Rio de Janeiro, RJ, Brazil.
authors.forename: Fátima
authors.initials: F
authors.lastname: Conceição-Silva
authors.affiliation: Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.|Department of Otorhinolaryngology and Ophthalmology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Cláudia Maria
authors.initials: CM
authors.lastname: Valete-Rosalino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D003371:Cough / Q000209:etiology; D003430:Cross-Sectional Studies; D003710:Demography; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000302:isolation & purification; D011859:Radiography; D012189:Retrospective Studies; D012907:Smoking; D013183:Sputum / Q000382:microbiology; D014387:Tuberculosis, Laryngeal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging