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.