ABSTRACT
Introduction The indirect laryngoscopy has an important role in the characterization of reflux laryngitis. Although many findings are nonspecific, some strongly suggest that the inflammation is the cause of reflux. Objective The aim of this study was to evaluate the correlation between reflux symptoms and the findings of indirect laryngoscopy. Methods We evaluated 27 patients with symptoms of pharyngolaryngeal reflux disease. Results Laryngoscopy demonstrated in all patients the presence of hypertrophy of the posterior commissure and laryngeal edema. The most frequent symptoms were the presence of dry cough and foreign body sensation. Conclusion There was a correlation between the findings at laryngoscopy and symptoms of reflux.
Subject(s)
Humans , Female , Young Adult , Middle Aged , Inflammation , Laryngopharyngeal Reflux , Laryngoscopy , Laryngitis/diagnosis , Signs and SymptomsABSTRACT
Croup is a frequent cause of outpatient and emergency consultation. It is frequently triggered by a viral respiratory infection and characterized by an abrupt onset. We describe current studies about the treatment of croup. The use of systemic corticosteroids stands out as choice treatment, and nebulized epinephrine as short term therapy while waiting for the anti-inflammatory effect of steroids.
El Croup (laringitis aguda) es motivo frecuente de consulta en servicios de urgencia y policlínicos pediátricos. Generalmente es gatillado por una infección respiratoria viral y se caracteriza por un inicio abrupto. En el presente texto se describen los estudios vigentes acerca de su tratamiento. Destacan los corticoides sistémicos como terapia de elección y la adrenalina nebulizada como terapia de acción corta en espera de la acción antinflamatoria esteroidal.
Subject(s)
Humans , Child , Croup/diagnosis , Croup/drug therapy , Adrenal Cortex Hormones/therapeutic use , Dexamethasone/therapeutic use , Laryngitis/diagnosis , Laryngitis/drug therapy , Prednisolone/therapeutic use , Respiratory SoundsABSTRACT
Les laryngites chroniques correspondent a une inflammation de la muqueuse laryngee d'une duree superieure a quinze jours. Leur frequence est difficile a apprecier. Le risque de transformation maligne a implique un interet particulier a cette pathologie avec une prise en charge rigoureuse en detectant les facteurs de risque et assurant une surveillance reguliere a long terme des lesions precancereuses. Leur prise en charge; doit identifier precisement ces lesions a l'aide d'une videoscopie laryngee et/ou d'une videostroboscopie. L'appreciation endoscopique des lesions laryngees; en recourant selon les possibilites a l'autofluorescence; est un imperatif qui permet; outre de classer la pathologie; de proposer dans le meme temps un traitement adapte. a cet effet; l'avenement des techniques lasers a constitue une avancee therapeutique dans la prise en charge de ces lesions. Le but de notre travail est rappeler l'ethiopathogenie; exposer les moyens de diagnostic; de traitement des laryngites chroniques et d'etablir un protocole de surveillance adequat en se referant a la litterature
Subject(s)
Endoscopy , Laryngitis/diagnosis , Laryngitis/etiology , StroboscopyABSTRACT
We present the problem of viral croup or acute laryngotracheitis as an important respiratory issue in children that often prompts parents to seek physician consultation. Despite its frequency, there is still controversy among the medical team regarding its treatment. The problem will be defined and analyzed in-depth in terms of pathogenesis, to finally suggest a simple, clinically effective treatment than can be applied in any emergency service. We highlight the importance of epinephrine and corticosteroids in the acute treatment of these patients...
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Croup/epidemiology , Croup/prevention & control , Laryngitis/diagnosis , Laryngitis/epidemiology , Laryngitis/etiology , Laryngitis/prevention & control , Laryngitis/therapySubject(s)
Humans , Infant , Child, Preschool , Bronchitis/diagnosis , Bronchitis/epidemiology , Laryngitis/diagnosis , Laryngitis/epidemiology , Pneumonia/diagnosis , Pneumonia/epidemiology , Whooping Cough/diagnosis , Whooping Cough/epidemiology , Bronchitis/therapy , Chile , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Influenza, Human/therapy , Laryngitis/therapy , Evidence-Based Medicine , Pneumonia/therapy , Whooping Cough/therapyABSTRACT
La laringitis aguda en niños es una patología frecuente, autolimitada, de breve duración: 2 a 7 días, causada por virus como influenza A y B, parainfluenza 1, 2 y 3, virus respiratorio sincitial (VRS) y adenovirus.Las infecciones prolongadas pueden involucrar otros patógenos; han sido reportados algunos casos de laringitis causadas por infecciones herpéticas, sobre todo por el virus herpes simple tipo 1 (VHS-1).Se sugiere la evaluación endoscópica de la vía aérea en casos de laringitis prolongadas para el diagnóstico e implementar medidas terapéuticas específicas para evitar complicaciones potencialmente graves. El uso de aciclovir ha demostrado ser efectivo en el tratamiento, siendo controvertido el uso de corticoides y antibióticos.Se presenta el caso de una niña de 7 meses con laringitis por Herpes virus, tratado con aciclovir...
Subject(s)
Humans , Female , Infant , Acyclovir/therapeutic use , Stomatitis, Herpetic/complications , Stomatitis, Herpetic/diagnosis , Stomatitis, Herpetic/therapy , Laryngitis/diagnosis , Laryngitis/etiology , Herpesvirus 1, HumanABSTRACT
To describe the causes of voice disorder [hoarseness] among general population attending E.N.T department in Abbasi Shaheed Hospital. It is the descriptive study of 100 patients, who enrolled from out patient department and admitted in E.N.T department of Abbasi Shaheed Hospital. The data was collected as per the specially designed Performa. This study was done in Abbasi Shaheed Hospital, Karachi. Most of the patient with hoarseness 38 [38%] were observed between 5-15 years followed by 16-24 years old 26 [26%] patients. The most common cause of hoarseness was vocal cord nodules 35 patients [35%] followed by acute laryngitis, 22 patients [22%] and chronic non specific laryngitis 14 patients [14%]. Hoarseness due to carcinoma of larynx, 13 patients [13%]
Subject(s)
Humans , Child, Preschool , Child , Adolescent , Adult , Male , Female , Hoarseness/diagnosis , Laryngitis/diagnosis , Age Distribution , Vocal Cords/pathology , IncidenceABSTRACT
Gastroesophageal reflux disease (GERD) often presents as typical symptoms such as heartburn or acid regurgitation. However, a subgroup of patients presents a collection of symptoms and signs that are not directly related to esophageal damage. These are known collectively as the extraesophageal manifestations of GERD, such as non-cardiac chest pain, laryngitis, chronic cough, hoarseness, asthma or dental erosion. They have a common pathophysiology, involving microaspiration of acid into the larynx and pharynx, and vagally mediated bronchospasm and laryngospasm. The role of extraesophageal reflux in such disorders is underestimated due to often silent symptoms and difficult confirmation of diagnosis. Endoscopy and pH monitoring are insensitive and therefore not useful in many patients as diagnostic modalities. Thus, anti-secretory therapy by proton pump inhibitor is used as both a diagnostic trial and as a therapy in the majority. Attention to optimizing therapy and judicious use of endoscopy and reflux monitoring are needed to maximize treatment success.
Subject(s)
Humans , Anti-Ulcer Agents/administration & dosage , Asthma/diagnosis , Cough/diagnosis , Esophageal pH Monitoring , Gastric Acidity Determination , Gastroesophageal Reflux/diagnosis , Hoarseness/diagnosis , Laryngitis/diagnosis , Omeprazole/administration & dosage , Prognosis , Proton Pump Inhibitors/therapeutic use , Tooth Erosion/diagnosisABSTRACT
Parvovirus-B19 has been reported a rare cause of acute laryngitis. Here, we described an 11-month-old girl who had prolonged acute laryngitis and neutropenia associated with parvovirus-B19 infection. Intravenous immunoglobulin therapy resulted in resolution of her symptoms, except neutropenia. We concluded that parvovirus-B19 can cause prolonged laryngitis and intravenous immunoglobulin treatment should be considered.
Subject(s)
Croup/diagnosis , Dexamethasone/therapeutic use , Diagnosis, Differential , Drug Therapy, Combination , Female , Humans , Imipenem/therapeutic use , Immunization, Passive , Infant , Laryngitis/diagnosis , Neutropenia/diagnosis , Parvoviridae Infections/diagnosis , Parvovirus B19, HumanABSTRACT
Chronic laryngitis is a lingering inflammation of the laryngeal mucosa, caused by specifc aetiology and often irritative factors. To discuss clinic and therapeutic aspects of the pathology. We report a retrospective study about 25 patients treated and followed for non specific chronic laryngitis over a period of 11 years [1994-2004]. The average age of the patients was 54, 2 years. Tobacco intoxication was noted in 72,7 of cases and Gastroesophageal reflux in 2 cases. The endoscopic examination of laryngeal lesions, realized in all cases, notes laryngeal keratosis in 88% of cases and congestive laryngitis in 12%. Histological analysis of the lesions reveals a dysplasia in 44% of cases. Clinical and endoscopic follow up of the patients discover malignant development in 5 patients. The treatment of chronic laryngitis is based on the suppression of etiologic factors and on laryngeal microsurgery with micro instruments and with laser techniques
Subject(s)
Humans , Male , Female , Laryngitis/therapy , Chronic Disease , Tobacco , Precancerous Conditions , Laser Therapy , Retrospective Studies , Laryngitis/diagnosisABSTRACT
A doença do refluxo gastroesofágico freqüentemente se apresenta com pirose e regurgitação, os chamados sintomas típicos. Porém, um subgrupo de pacientes apresenta um conjunto de sinais e sintomas que não estão relacionados diretamente ao dano esofágico. A esse conjunto dá-se o nome de manifestações extra-esofágicas da doença do refluxo gastroesofágico. Compreendem, principalmente, broncoespasmo, tosse crônica e alterações inflamatórias na laringe (chamados manifestações atípicas). Apesar de essas manifestações formarem um grupo heterogêneo, algumas considerações gerais englobam todos os subgrupos: embora a associação entre a doença do refluxo gastroesofágico e as manifestações extra-esofágicas esteja bem estabelecida, uma relação entre causa e efeito definitiva ainda não está elucidada; em relação à patogênese das manifestações extra-esofágicas, os principais mecanismos propostos são a injúria direta do tecido extra-esofágico pelo conteúdo ácido gástrico refluído e o reflexo esôfago-brônquico mediado pelo nervo vago; a doença do refluxo gastroesofágico pode não ser incluída no diagnóstico diferencial do grupo de pacientes que apresenta somente os sintomas atípicos. Este artigo revisa as manifestações extra-esofágicas da doença do refluxo gastroesofágico encontradas na literatura, discutindo a epidemiologia, patogênese, diagnóstico e tratamento, com foco nas apresentações mais estudadas e estabelecidas.
Subject(s)
Humans , Gastroesophageal Reflux/complications , Lung Diseases/etiology , Otorhinolaryngologic Diseases/etiology , Asthma/diagnosis , Asthma/etiology , Asthma/therapy , Chronic Disease , Cough/diagnosis , Cough/etiology , Cough/therapy , Fundoplication , Gastroesophageal Reflux/therapy , Laparoscopy , Laryngitis/diagnosis , Laryngitis/etiology , Laryngitis/therapy , Lung Diseases/diagnosis , Lung Diseases/therapy , Otorhinolaryngologic Diseases/diagnosis , Otorhinolaryngologic Diseases/therapy , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/etiology , Pulmonary Fibrosis/therapyABSTRACT
INTRODUÇÃO: A Doença do Refluxo Gastroesofágico (DRGE) é a doença digestiva mais prevalente da atualidade e, recentemente, tem sido implicada em uma gama de alterações do seguimento laringofaríngeo (RLF). No entanto, pouco se sabe dos mecanismos fisiopatológicos destas manifestações supraesofágicas da DRGE. Os achados clínicos contraditórios e recentes pesquisas sugerem haver deficiências na capacidade de defesa deste seguimento. Uma das principais responsáveis pela homeostase da mucosa oral e do trato digestivo é a saliva com seu conteúdo orgânico e inorgânico. Tanto alterações do pH quanto do volume salivar já foram correlacionados com os sintomas e sinais sugestivos da DRGE e RLF. Estudo recente de nossa autoria demonstra diminuição estatisticamente significante do pH salivar de indivíduos com RLF quando comparado a controles sem a doença. Outro estudo constatou correlação entre a redução do volume X pH da saliva em indivíduos com DRGE, estando esta redução diretamente relacionada aos níveis de pH esofágico constatados durante pH-metria esofágica de 24 horas. OBJETIVOS: Avaliar como se comportam o pH e volume da saliva em um mesmo indivíduo com DRGE e RLF antes e após o tratamento clínico. MATERIAL E MÉTODO: Vinte e três pacientes com RLF tiveram o pH e volume da saliva total testados antes e após receberem tratamento com droga bloqueadora de bomba de prótons durante 12 semanas. RESULTADOS: Houve uma diferença estatisticamente significante (p<0,001) entre o pH da saliva antes e após o tratamento, estando este maior após o controle clínico da doença. O volume de saliva no paciente tratado foi significativamente maior do que no paciente pré-tratamento (p=0.009). DISCUSSÃO: Os achados sugerem que o pH salivar é influenciado pela presença de refluxo gastroduodenal à região laringofaríngea. Caso estudos futuros com populações maiores realmente comprovem esta correlação, poderemos cogitar a possibilidade de usar a mensuração do pH salivar, que é feita de forma rápida e não invasiva, como um meio de diagnosticar e avaliar o comportamento e controle do Refluxo Laringofaríngeo.
INTRODUCTION: Gastroesophageal Reflux Disease (GERD) is the most prevalent digestive disease of the modern society and has been associated with abnormalities in the larynx and pharynx (LPR). Nonetheless, little is known about the mechanisms involved in this atypical form of the disease. Contradictory clinical data suggest a defense deficit at this segment. Saliva with its organic and inorganic components is responsible for the homeostasis of the oral mucosa and the digestive tract. Salivary pH and volume abnormalities have been linked to laryngopharyngeal symptoms of GERD and LPR. In a recent study we demonstrated significant salivary pH reduction in patients with LPR. Another study found correlation between reduced salivary pH and volume directly related to esophageal pH-metry results. AIM: To evaluate salivary pH and volume before and after clinical treatment of LPR. MATERIAL AND METHOD: Twenty-three adults with LPR had total fasting saliva tested before and after a 12-week course of oral proton pump inhibitor. RESULTS: A statistically significant difference was found in salivary pH before and after treatment with increase of pH values after control of the disease (p<0.001). Salivary volumes of treated patients were also significantly higher than in pre-treated patients (p=0.009). DISCUSSION: These findings suggest that salivary pH and volume are influenced by the presence of gastroesophageal contents and that salivary pH monitoring can potentially become a cost-effective method for diagnosing and controlling LPR.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Proton Pumps/antagonists & inhibitors , Pharyngitis/diagnosis , Laryngitis/diagnosis , Omeprazole/therapeutic use , Saliva/chemistry , Proton Pumps/pharmacology , Chronic Disease , Hydrogen-Ion Concentration/drug effects , Pharyngitis/drug therapy , Pharyngitis/etiology , Laryngitis/drug therapy , Laryngitis/etiology , Manometry , Monitoring, Physiologic , Omeprazole/pharmacology , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/drug therapy , Saliva/drug effects , SalivaABSTRACT
Rheumatoid arthritis [RA] is a chronic inflammatory disease affecting the synovial membrane, which causes joint damage and bone destruction. The crico arytenoid joint is a true diarthroidial synovial joint that can be affected by RA. In this study, disease activity, clinical assessment of the larynx, fiberoptic nasolaryngoscopy and Multi-Slides Computed Tomography [MSCT] were done to 20 RA patients in order to define the laryngeal involvement in rheumatoid arthritis patients. 14 of the 20 patients [70%] had laryngeal symptoms related to CA arthritis. Laryngeal endoscopy showed abnormalities in 9 of 20 patients [45%]. 5 of the 20 patients [25%], had abnormal radiologic findings related to CA arthritis. Laryngeal symptoms attributable to laryngeal involvement could be predictive of abnormal endoscopic and radiologic findings. Laryngeal involvement in RA could be attributed to the current disease activity and are more frequent with longer disease duration
Subject(s)
Humans , Female , Larynx , Laryngitis/diagnosis , Tomography, X-Ray Computed , Chronic Disease , LaryngoscopyABSTRACT
Se presentan dis casos clínicos de niños menores de 3 años, ambos con sintomatología laríngea, en quienes la electromiografía larígea permitió hacer el diagnóstico etiológicode su patología. En el primero de ellos existía una paresia vocal unilateral por compromiso del nervio vago, y en el segundo caso había una parálisis cordal bilateral por fijación de cuerdas vocales, secundaria a intubación orotraqueal
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Laryngeal Diseases/diagnosis , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/etiology , Laryngitis/diagnosis , Diagnosis, Differential , Electromyography/methodsSubject(s)
Humans , Child , Handbook , Respiratory Tract Diseases/prevention & control , Pneumonia/diagnosis , Pneumonia/therapy , Asthma/diagnosis , Asthma/therapy , Tuberculosis/diagnosis , Tuberculosis/therapy , Bronchiolitis, Viral/diagnosis , Bronchiolitis, Viral/therapy , Rhinitis/diagnosis , Rhinitis/therapy , Laryngitis/diagnosis , Laryngitis/therapyABSTRACT
Os autores descrevem as estrias das cordas vocais (vergetures) como uma patologia pouco comum na Laringologia. Comentam sua histopatologia, salientando as características atróficas e aderentes da mucosa das cordas vocais aos planos profundos. Discutem 32 casos de estrias das cordas vocais associados ou nao a outras patologias e concluem pela importância da suspeita diagnóstica de estrias diante da imagem glótica ovalar.
Subject(s)
Humans , Laryngitis/diagnosis , Vocal Cords/pathologyABSTRACT
We have used a new designed croup score to determine its importance in categorizing cases according to severity and in rapid planning of the method of treatment. We investigated 60 patients in a randomized study. Where they were grouped into three groups according to their croup score. The groups were observed for duration of stridor, changes in 0[2] saturation, heart rate respiratory rate and for the effectiveness of treatment. The results of the study showed the differences in the previous factors according to the level of the croup score. The study proved the beneficial effect of the numerical score in easy and rapid management of the croup patients. The study recommend the direct involvement of E.N.T surgeon and anesthesiologisl in the management of patients with croup score between 13 - 18
Subject(s)
Humans , Male , Female , Laryngitis/diagnosis , OxygenABSTRACT
Las enfermedades de vías respiratorias superiores y sus complicaciones pueden poner en peligro la vida; por consiguiente, se necesita un método sistemático para el diagnóstico rápido y tratamiento adecuado. Al analizar los signos y síntomas se puede establecer un diagnóstico diferencial. Las infecciones graves de vías respiratorias superiores pueden situarse en tres categorías expuestas en este artículo: síndrome catarral agudo, síndrome de amigdalofaringitis o síndrome de crup laríngeo. Este sistema de clasificación hace que el diagnóstico sea rápido y permita que el tratamiento adecuado se inicie con prontitud