Laryngeal tuberculosis is characterized by the formation of foci of specific inflammation in the affected tissues. It is a constant companion of pulmonary tuberculosis. It occurs due to the penetration of the tubercle bacillus from the foci of the disease. Laryngeal tuberculosis is contagious; potential bacteria-producing patients include patients with active tuberculosis who ignore treatment. Even with a favorable course and the use of modern methods of treatment, tuberculosis of the larynx is difficult to treat.
Causes
Basically, infection occurs by airborne droplets. Some patients excrete several billions of mycobacteria per day. People nearby inhale them and become infected.
You can also get it through blood or lymph.
Contribute to the occurrence of tuberculosis of the larynx:
- chronic lung disease;
- diabetes;
- smoking;
- alcoholism;
- work in polluted air.
As a result of these factors, immunity is weakened, and the human body cannot cope with acid-fast mycobacteria. More often men are ill, in women in most registered cases of laryngeal tuberculosis is detected during pregnancy or after childbirth. The main reason for this is the complications of the socio-economic and environmental situation in the country.
Classification of tuberculosis of the larynx
Laryngeal tuberculosis occurs only in adults. He is always accompanied by tuberculosis of the lungs or other organs. Laryngeal tuberculosis is classified according to the location and prevalence of the process and phase in the larynx, as well as the presence of bacterial secretion.
In accordance with the localization and prevalence of the process in the larynx
note the defeat:
- epiglottis. The patient's fingertips begin to turn blue, cyanosis appears around the mouth due to lack of oxygen;
- sub-voice space. This lesion negatively affects the production of sound. The vocal folds lose their elasticity, thicken and shorten;
- laryngeal ventricles. This defeat does not manifest itself for a long time;
- vestibular folds. Their mobility is limited, so breathing becomes difficult;
- intercarpal space. It is characterized by sharp pain when swallowing;
- arytenoid cartilage. This damage makes it difficult to inhale and exhale.
Monochorditis also appears - fatigue of the voice. His timbre changes, over time it becomes difficult for the patient to speak.
In accordance with the phase of the tuberculous process
you can determine the period of the disease:
- at the stage of infiltration, the mucous layer of the pharynx begins to thicken, small tubercles appear;
- at the stage of ulceration, malodorous tumor ulcers with profuse bloody discharge are formed;
- at the stage of decay, a cough with mucopurulent sputum appears, gurgling wheezing in the lungs, hemoptysis and release of MVT;
- then comes the compaction stage. If induration does not occur, the disease is in remission;
- scarring leads to persistent narrowing of the lumen of the larynx.
In some patients, cases of rapid healing of tuberculosis of the larynx were observed with timely treatment. After the course, young connective tissue begins to grow, and tuberculous changes completely disappear.
By the presence of bacterial excretion
The presence of bacterial secretion (MBT +) is a necessary indicator of danger; you can become infected with tuberculosis only from a patient who secretes mycobacteria. Patients who do not emit mycobacteria (MBT-) are not dangerous to others, since the disease passes in a closed form.
The pathogenesis of tuberculosis of the larynx
Laryngeal tuberculosis begins with general intoxication of the body. In the larynx, the causative agent of the disease mainly enters the aerogenic route, but often infection occurs through the alimentary route. Infection with tuberculosis of the larynx penetrates from the sputum of the pulmonary focus. Often, infection occurs by the hematogenous route, that is, it is transmitted through the blood. Sometimes the infection of the larynx comes from the lymph nodes.
Development of tuberculosis of the larynx
The tuberculous process in the larynx takes various forms. Mycobacteria invade the mucous tissue of the larynx and infect the human body.
Infiltration formation
With infiltrative forms of tuberculosis of the larynx, the mucous membrane of the larynx thickens. The affected epiglottis swells and hangs over the entrance to the larynx in the form of a turban, closing the passage. Complaints at this stage are rare.
Ulcer formation
With the progression of infiltrative tuberculosis of the larynx, inflammation appears, turning into ulcers, constantly increasing in size.
Cartilage damage
With the progression of the disease, a pathological process occurs with damage to cartilage and muscles. In some cases, the epiglottis can be completely destroyed.
Laryngeal tuberculosis symptoms
In order to timely recognize tuberculosis of the larynx, you should know the symptoms of the disease. Already at the beginning of the development of the disease, the patient develops dry and sore throat, as well as pain while eating. The patient often experiences severe shortness of breath. The cough is very characteristic: hoarse and soundless.
After a while, the patient develops chills, the temperature rises, and breathing becomes difficult. Over time, the voice begins to change, it becomes hoarse, unpleasant. Hemoptysis begins, but this is an uncharacteristic sign of tuberculosis of the larynx.
Patients lose a lot of weight, as food intake becomes very painful.
If treatment is not started, damage to the cartilaginous joints begins.
Diagnostics
The diagnosis of tuberculosis of the larynx is carried out by an otolaryngologist. After the laryngoscopy, before making the final diagnosis, the doctor directs the patient to laboratory tests, such as:
- microlaryngoscopy;
- sputum analysis for CFB;
- general blood analysis;
- tuberculin tests;
- RPR test;
- pathomorphological examination of biopsies from the larynx, to determine the epithelioid cells.
In doubtful cases, they are referred for endoscopic biopsy and histological examination.
Also, the otolaryngologist examines the voice function, conducts phonetography, ultrasound to assess destructive processes and differentiate tuberculosis of the larynx from other similar diseases: syphilis, laryngeal cancer, diphtheria, granulomatosis or a benign tumor.
Treatment of tuberculosis of the larynx
Correct diagnosis of this disease is very difficult. But in the medical center "Clinic K + 31", thanks to modern high-precision equipment for the diagnosis and treatment of tuberculosis, such difficulties do not arise. Therefore, doctors can make the correct diagnosis, even at an early stage of the disease, and promptly eliminate foci of the disease.
Doctors select individual treatment for each patient. Thanks to the professional and attentive attitude of the doctors of the clinic "Clinic K + 31", after the course of treatment, patients recover their voice and respiratory function and return to normal life.
