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Archives of Disease in Childhood Mar 1983During a 2-year period, 7 children were seen with a severe form of laryngotracheobronchitis associated with sloughing of the respiratory epithelium and profuse...
During a 2-year period, 7 children were seen with a severe form of laryngotracheobronchitis associated with sloughing of the respiratory epithelium and profuse mucopurulent secretions. We have called this condition pseudomembranous croup. The children had severe upper airways obstruction, appeared toxic with high fever, and were older than the typical age group for viral laryngotracheobronchitis. Lateral x-ray films of the airways showed subglottic narrowing and often these suggested the presence of radio-opaque foreign material in the tracheal lumen. At endoscopy, in addition to pseudomembrane in the subglottic region and trachea, there was thick mucopus and debris, and in some cases these changes extended into the bronchi. An artificial airway was required in all except one, and even after intubation it proved difficult to maintain the airway. Staphylococcus aureus was the most common pathogen isolated from tracheal cultures but other organisms were grown.
Topics: Airway Obstruction; Child; Child, Preschool; Croup; Diagnosis, Differential; Female; Humans; Infant; Intubation, Intratracheal; Laryngitis; Male; Tracheotomy
PubMed: 6838248
DOI: 10.1136/adc.58.3.180 -
Brazilian Journal of Otorhinolaryngology 2023To establish if the Reflux Symptom Index (RFI) and the Reflux Finding Score (RFC) can help establish the differential diagnosis in patients with distinct causes of...
OBJECTIVE
To establish if the Reflux Symptom Index (RFI) and the Reflux Finding Score (RFC) can help establish the differential diagnosis in patients with distinct causes of chronic laryngopharyngitis.
METHODS
A group of 102 adult patients with chronic laryngopharyngitis (Group A - 37 patients with allergic rhinitis; Group B - 22 patients with Obstructive Sleep Apnea (OSA); Group C - 43 patients with Laryngopharyngeal Reflux (LPR)) were prospectively studied. Chronic laryngitis was diagnosed based on suggestive symptoms and videolaryngoscopic signs (RSI ≥ 13 and RFS ≥ 7). Allergies were confirmed by a positive serum RAST, OSA was diagnosed with a positive polysomnography, and LPR with a positive impedance-PH study. Discriminant function analysis was used to determine if the combination of RSI and RFS scores could differentiate between groups.
RESULTS
Patients with respiratory allergies and those with LPR showed similar and significantly higher RSI scores when compared to that of patients with OSA (p < 0.001); Patients with OSA and those with LPR showed similar and significantly higher RFS scores when compared to that of patients with Respiratory Allergies (OSA vs. Allergies p < 0.001; LPR vs. Allergies p < 0.002). The combination of both scores held a higher probability of diagnosing OSA (72.73%) and Allergies (64.86%) than diagnosing LPR (51.16%).
CONCLUSIONS
RSI and RFS are not specific for reflux laryngitis and are more likely to induce a false diagnosis if not used with diligence.
Topics: Adult; Humans; Laryngitis; Laryngopharyngeal Reflux; Chronic Disease; Sleep Apnea, Obstructive; Hypersensitivity
PubMed: 34840124
DOI: 10.1016/j.bjorl.2021.08.003 -
Ear, Nose, & Throat Journal Jul 2021
Topics: Aged; Clindamycin; Esophagitis; Humans; Laryngitis; Male; Medical Illustration
PubMed: 31569974
DOI: 10.1177/0145561319875138 -
Cellular and Molecular Life Sciences :... Oct 2020The larynx and vocal folds sit at the crossroad between digestive and respiratory tracts and fulfill multiple functions related to breathing, protection and phonation.... (Review)
Review
The larynx and vocal folds sit at the crossroad between digestive and respiratory tracts and fulfill multiple functions related to breathing, protection and phonation. They develop at the head and trunk interface through a sequence of morphogenetic events that require precise temporo-spatial coordination. We are beginning to understand some of the molecular and cellular mechanisms that underlie critical processes such as specification of the laryngeal field, epithelial lamina formation and recanalization as well as the development and differentiation of mesenchymal cell populations. Nevertheless, many gaps remain in our knowledge, the filling of which is essential for understanding congenital laryngeal disorders and the evaluation and treatment approaches in human patients. This review highlights recent advances in our understanding of the laryngeal embryogenesis. Proposed genes and signaling pathways that are critical for the laryngeal development have a potential to be harnessed in the field of regenerative medicine.
Topics: Animals; Cell Differentiation; Humans; Laryngeal Diseases; Larynx; Mesenchymal Stem Cells; SOXB1 Transcription Factors; Signal Transduction; Thyroid Nuclear Factor 1; Vocal Cords
PubMed: 32253462
DOI: 10.1007/s00018-020-03506-x -
Auris, Nasus, Larynx Aug 2023The COVID-19 omicron variant has a low affinity for the lower respiratory tract. However, upper respiratory tract symptoms, such as nasal discharge and sore throat,...
OBJECTIVES
The COVID-19 omicron variant has a low affinity for the lower respiratory tract. However, upper respiratory tract symptoms, such as nasal discharge and sore throat, characterize the infection with this variant. Therefore, in laryngeal stenosis, disease severity assessment through blood oxygen saturation has not been useful.
METHODS
We report the case of "omicron laryngitis" in a 59-year-old male who visited the ear, nose, and throat (ENT) clinic with complaints of a sore throat and difficulty in swallowing saliva that persisted for a day.
RESULTS
Laryngoscopy revealed severe swelling of the transglottic region and exudates on the larynx. He was then diagnosed with COVID-19 and subjected to emergency tracheostomy for airway management. Until the emergence of the omicron variant, COVID-19 showed mainly lower airway and mild upper airway inflammatory features. However, upper airway stenosis should be suspected in cases presenting with "muffled speech," "dysphagia," "severe pain on swallowing," and "inspiratory dyspnea or stridor."
CONCLUSION
Therefore, laryngeal and pharyngeal evaluation using a flexible laryngoscope under appropriate infection control measures is necessary, considering the possibility of progression to fatal laryngeal stenosis, as noted in this case.
Topics: Male; Humans; Middle Aged; Laryngitis; Laryngostenosis; COVID-19; SARS-CoV-2; Pharyngitis
PubMed: 36114072
DOI: 10.1016/j.anl.2022.08.007 -
American Family Physician Aug 2009Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx.... (Review)
Review
Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx. Evaluation of a patient with hoarseness includes a careful history, physical examination, and in many cases, laryngoscopy. Any patient with hoarseness lasting longer than two weeks in the absence of an apparent benign cause requires a thorough evaluation of the larynx by direct or indirect laryngoscopy. The management of hoarseness includes identification and treatment of any underlying conditions, vocal hygiene, voice therapy, and specific treatment of vocal cord lesions. Vocal hygiene education is an integral aspect of the treatment of hoarseness in most cases. Referral to a speech-language pathologist for voice therapy may be particularly helpful for patients whose occupation depends on singing or talking loudly or for prolonged periods. Voice therapy is an effective method for improving voice quality and vocal performance in patients with nonorganic dysphonia and for treating many benign pathologic vocal cord lesions. Referral for surgical or other targeted interventions is indicated when conservative management of vocal cord pathology is unsuccessful, when dysplasia or carcinoma is suspected, or when significant airway obstruction is present.
Topics: Adult; Hoarseness; Humans; Laryngitis; Laryngoscopy; Physical Examination; Vocal Cord Paralysis; Voice Quality
PubMed: 19678604
DOI: No ID Found -
British Medical Journal (Clinical... Oct 1981
Topics: Child; Diagnosis, Differential; Epiglottis; Humans; Intubation, Intratracheal; Laryngitis; Respiratory Sounds
PubMed: 6794785
DOI: 10.1136/bmj.283.6299.1122-a -
British Medical Journal (Clinical... Sep 1981
Topics: Child; Child, Preschool; Diagnosis, Differential; Epiglottis; Humans; Infant; Laryngitis; Respiratory Sounds
PubMed: 6793144
DOI: No ID Found -
British Medical Journal (Clinical... Nov 1981
Topics: Child; Child, Preschool; Croup; Epiglottis; Humans; Laryngitis; Respiratory Sounds
PubMed: 6797583
DOI: 10.1136/bmj.283.6304.1468-a -
Anaesthesia Nov 1985
Topics: Adult; Child; Epiglottis; Epiglottitis; Humans; Laryngitis; Radiography; Respiration, Artificial
PubMed: 4073433
DOI: 10.1111/j.1365-2044.1985.tb10620.x