Chronic laryngitis (慢性喉炎)

Chronic non-specific laryngitis (慢性非特異性喉炎)

Aetiology:

Common. Usually associated with vocal abuse, smoking or sepsis elsewhere in the respiratory tract, e.g. chronic sinusitis.

Clinical features:

Hoarseness may be accompanied by sore throat. Indirect laryngoscopy may distinguish localized forms, e.g. singer’s nodules, Reinke’s oedema or laryngeal polyps, from the generalized forms, e.g. chronic hypertrophic laryngitis.

Management:

Treatment involves the removal of any precipitating factors and speech therapy is important. Localized polyps or nodules may merit endoscopic removal.

Chronic specific laryngitis (慢性特異性喉炎)

Rare. Most of the granulomatous diseases can involve the larynx, e.g. tuberculosis, syphilis, sarcoidosis, scleroma or Wegener’s granulomatosis.

Management:

The lesions may mimic a carcinoma and a direct laryngoscopy and biopsy is mandatory. Treatment is that of the underlying systemic condition.

Leukoplakia (聲帶白斑)

Usually affects the true cords. The aetiology is as for chronic non-specific laryngitis. Microscopically, the findings of hyperkeratosis and dysplasia are common, although in situ or invasive carcinoma can only be excluded by an adequate biopsy.

Management:

Endoscopy should be undertaken in all cases. Leukoplakia should be regarded as having the potential to undergo malignant change.