S G Romanenko, E A Kirasirova, O G Pavlikhin, O V Eliseev, D I Kurbanova, E V Lesogorova, E N Krasilnikova
{"title":"溃疡性喉炎的临床特点。","authors":"S G Romanenko, E A Kirasirova, O G Pavlikhin, O V Eliseev, D I Kurbanova, E V Lesogorova, E N Krasilnikova","doi":"10.17116/otorino20259002120","DOIUrl":null,"url":null,"abstract":"<p><p>Ulcerative laryngitis refers to rare diseases, it is also called prolonged ulcerative laryngitis, idiopathic ulcerative laryngitis and acute ulcerative laryngitis.</p><p><strong>Objective: </strong>To increase the effectiveness of treatment of patients with ulcerative laryngitis based on the study of the clinical features of the disease and evaluation of treatment results.</p><p><strong>Material and methods: </strong>The results of the examination (collection of complaints and anamnesis, general otorhinolaryngological examination, indirect microlaryngoscopy, videolaryngostroboscopy, microbiological studies, subjective assessment of vocal function) and treatment of 20 patients with ulcerative laryngitis who applied to the phoniatric unit of the Sverzhevsky Research Clinical Institute of Otorhinolaryngology (Moscow, Russia) are presented.</p><p><strong>Results: </strong>The study group consisted of 16 women and 4 men aged 19 to 73 years (median 47.5 years). In all patients, the disease is associated with a prolonged or subacute cough. The duration of dysphonia ranged from 1 to 10 months (2.6 months on average). A history of smoking was detected in 7 patients, increased vocal load in 5. The clinical picture in all patients was similar: dysphonia and cough. Video laryngoscopy revealed hyperemia and infiltration of the vocal folds with the presence of erosions or ulcers covered with fibrin, located symmetrically in the middle third of the vocal folds along the free edge with a transition to the upper surface. Video pharyngostroboscopy revealed a decrease in the amplitude and irregularity of vibrations in the erosion zone, and the preservation of the mucous wave in the remaining parts of the vocal folds. Microbiological examination revealed fungal flora in 4 patients and bacterial flora in 4 patients. The duration of treatment averaged 9.6 weeks, while the healing of ulcerative defects of the vocal folds occurred 2-4 weeks after the cessation of coughing. Phonopedic classes were needed by 2 patients. In 1 case, surgical treatment was required. Laryngeal contact granuloma was detected in 2 patients with ulcerative laryngitis. Granuloma regression is achieved with the help of conservative therapy. The restoration of voice as a result of the treatment was achieved in all patients.</p><p><strong>Conclusion: </strong>Ulcerative laryngitis is a rare disease associated with vocal injury, characterized by dysphonia, bilateral and symmetrical ulcerative defects in the middle third of the vocal folds, and prolonged healing. It is necessary to conduct a microbiological examination at the first treatment of a patient with this pathology. Treatment should be individual and comprehensive. Surgical treatment is indicated in exceptional cases for the differential diagnosis of laryngeal cancer. Phonopedia may be required. Long-term monitoring of the patient is necessary until full recovery and restoration of voice function.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"90 2","pages":"20-25"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Clinical features of ulcerative laryngitis].\",\"authors\":\"S G Romanenko, E A Kirasirova, O G Pavlikhin, O V Eliseev, D I Kurbanova, E V Lesogorova, E N Krasilnikova\",\"doi\":\"10.17116/otorino20259002120\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Ulcerative laryngitis refers to rare diseases, it is also called prolonged ulcerative laryngitis, idiopathic ulcerative laryngitis and acute ulcerative laryngitis.</p><p><strong>Objective: </strong>To increase the effectiveness of treatment of patients with ulcerative laryngitis based on the study of the clinical features of the disease and evaluation of treatment results.</p><p><strong>Material and methods: </strong>The results of the examination (collection of complaints and anamnesis, general otorhinolaryngological examination, indirect microlaryngoscopy, videolaryngostroboscopy, microbiological studies, subjective assessment of vocal function) and treatment of 20 patients with ulcerative laryngitis who applied to the phoniatric unit of the Sverzhevsky Research Clinical Institute of Otorhinolaryngology (Moscow, Russia) are presented.</p><p><strong>Results: </strong>The study group consisted of 16 women and 4 men aged 19 to 73 years (median 47.5 years). In all patients, the disease is associated with a prolonged or subacute cough. The duration of dysphonia ranged from 1 to 10 months (2.6 months on average). A history of smoking was detected in 7 patients, increased vocal load in 5. The clinical picture in all patients was similar: dysphonia and cough. Video laryngoscopy revealed hyperemia and infiltration of the vocal folds with the presence of erosions or ulcers covered with fibrin, located symmetrically in the middle third of the vocal folds along the free edge with a transition to the upper surface. Video pharyngostroboscopy revealed a decrease in the amplitude and irregularity of vibrations in the erosion zone, and the preservation of the mucous wave in the remaining parts of the vocal folds. Microbiological examination revealed fungal flora in 4 patients and bacterial flora in 4 patients. The duration of treatment averaged 9.6 weeks, while the healing of ulcerative defects of the vocal folds occurred 2-4 weeks after the cessation of coughing. Phonopedic classes were needed by 2 patients. In 1 case, surgical treatment was required. Laryngeal contact granuloma was detected in 2 patients with ulcerative laryngitis. Granuloma regression is achieved with the help of conservative therapy. The restoration of voice as a result of the treatment was achieved in all patients.</p><p><strong>Conclusion: </strong>Ulcerative laryngitis is a rare disease associated with vocal injury, characterized by dysphonia, bilateral and symmetrical ulcerative defects in the middle third of the vocal folds, and prolonged healing. It is necessary to conduct a microbiological examination at the first treatment of a patient with this pathology. Treatment should be individual and comprehensive. Surgical treatment is indicated in exceptional cases for the differential diagnosis of laryngeal cancer. Phonopedia may be required. Long-term monitoring of the patient is necessary until full recovery and restoration of voice function.</p>\",\"PeriodicalId\":23575,\"journal\":{\"name\":\"Vestnik otorinolaringologii\",\"volume\":\"90 2\",\"pages\":\"20-25\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vestnik otorinolaringologii\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17116/otorino20259002120\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vestnik otorinolaringologii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17116/otorino20259002120","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
溃疡性喉炎是指罕见病,又称延长性溃疡性喉炎、特发性溃疡性喉炎和急性溃疡性喉炎。目的:通过对溃疡性喉炎临床特点的研究和对治疗效果的评价,提高对溃疡性喉炎的治疗效果。材料与方法:本文报道了俄罗斯莫斯科Sverzhevsky临床耳鼻喉科学研究所(Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Sverzhevsky)语音科收治的20例溃疡性喉炎患者的检查结果(主诉和记忆收集、普通耳鼻喉检查、间接显微喉镜检查、视频喉频闪检查、微生物学研究、声乐功能主观评估)和治疗方法。结果:研究组包括16名女性和4名男性,年龄19至73岁(中位47.5岁)。所有患者均伴有长时间或亚急性咳嗽。语音障碍持续时间为1 ~ 10个月,平均2.6个月。7例有吸烟史,5例声带负荷增高。所有患者的临床表现相似:发音困难和咳嗽。视频喉镜检查显示声带充血和浸润,伴有纤维蛋白覆盖的糜烂或溃疡,沿自由边缘对称地位于声带中间三分之一处,并向上表面过渡。视频咽部频闪检查显示糜烂区振动的振幅和不规则性降低,声带其余部分的粘膜波保留。微生物学检查发现真菌菌群4例,细菌菌群4例。治疗时间平均9.6周,声带溃疡性缺损在咳嗽停止后2 ~ 4周愈合。2例患者需进行音像学分类。1例需要手术治疗。2例溃疡性喉炎患者发现喉部接触性肉芽肿。肉芽肿消退是在保守治疗的帮助下实现的。治疗后,所有患者均恢复了声音。结论:溃疡性喉炎是一种罕见的与声带损伤相关的疾病,以发声困难、双侧及对称的声带中三分之一处溃疡性缺损为特征,且愈合时间较长。这是必要的进行微生物检查在第一次治疗的病人与这种病理。治疗应该是个体化的和全面的。手术治疗是指在特殊情况下喉癌的鉴别诊断。可能需要音像库。长期监测患者是必要的,直到完全恢复和恢复语音功能。
Ulcerative laryngitis refers to rare diseases, it is also called prolonged ulcerative laryngitis, idiopathic ulcerative laryngitis and acute ulcerative laryngitis.
Objective: To increase the effectiveness of treatment of patients with ulcerative laryngitis based on the study of the clinical features of the disease and evaluation of treatment results.
Material and methods: The results of the examination (collection of complaints and anamnesis, general otorhinolaryngological examination, indirect microlaryngoscopy, videolaryngostroboscopy, microbiological studies, subjective assessment of vocal function) and treatment of 20 patients with ulcerative laryngitis who applied to the phoniatric unit of the Sverzhevsky Research Clinical Institute of Otorhinolaryngology (Moscow, Russia) are presented.
Results: The study group consisted of 16 women and 4 men aged 19 to 73 years (median 47.5 years). In all patients, the disease is associated with a prolonged or subacute cough. The duration of dysphonia ranged from 1 to 10 months (2.6 months on average). A history of smoking was detected in 7 patients, increased vocal load in 5. The clinical picture in all patients was similar: dysphonia and cough. Video laryngoscopy revealed hyperemia and infiltration of the vocal folds with the presence of erosions or ulcers covered with fibrin, located symmetrically in the middle third of the vocal folds along the free edge with a transition to the upper surface. Video pharyngostroboscopy revealed a decrease in the amplitude and irregularity of vibrations in the erosion zone, and the preservation of the mucous wave in the remaining parts of the vocal folds. Microbiological examination revealed fungal flora in 4 patients and bacterial flora in 4 patients. The duration of treatment averaged 9.6 weeks, while the healing of ulcerative defects of the vocal folds occurred 2-4 weeks after the cessation of coughing. Phonopedic classes were needed by 2 patients. In 1 case, surgical treatment was required. Laryngeal contact granuloma was detected in 2 patients with ulcerative laryngitis. Granuloma regression is achieved with the help of conservative therapy. The restoration of voice as a result of the treatment was achieved in all patients.
Conclusion: Ulcerative laryngitis is a rare disease associated with vocal injury, characterized by dysphonia, bilateral and symmetrical ulcerative defects in the middle third of the vocal folds, and prolonged healing. It is necessary to conduct a microbiological examination at the first treatment of a patient with this pathology. Treatment should be individual and comprehensive. Surgical treatment is indicated in exceptional cases for the differential diagnosis of laryngeal cancer. Phonopedia may be required. Long-term monitoring of the patient is necessary until full recovery and restoration of voice function.