International Journal of Phonosurgery & Laryngology

Register      Login

VOLUME 11 , ISSUE 2 ( July-December, 2021 ) > List of Articles

Original Article

A Retrospective Study of Granulomatous Lesions of the Larynx: Decision-making in Malignant Mimickers

Nupur K Nerurkar, Shruti Dhingra, KM Ranjita

Keywords : Granulomatous lesions, Hoarseness, Larynx, Subglottic stenosis

Citation Information : Nerurkar NK, Dhingra S, Ranjita K. A Retrospective Study of Granulomatous Lesions of the Larynx: Decision-making in Malignant Mimickers. Int J Phonosurg Laryngol 2021; 11 (2):39-45.

DOI: 10.5005/jp-journals-10023-1225

License: CC BY-NC 4.0

Published Online: 28-02-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Granulomatous conditions of the larynx constitute a heterogeneous group of lesions with overlapping symptoms. Many laryngoscopy findings are nonspecific, often confusing, with few systemic manifestations, and sometimes present as acute airway emergencies. It is imperative that the laryngologist suspects the possibility of such lesions when the presentation is atypical and the diagnosis does not “fit” in the classical scheme. Most cases may be managed conservatively avoiding an unnecessary tracheostomy. The correct approach undertaken at this time is crucial in determining the prognosis of the patient. An effective strategy involves multidisciplinary teams and a keen eye for systemic features, before undertaking any surgical intervention. Most granulomatous diseases show a definite regional preponderance but with the increase in immunocompromised conditions and globalization, this trend is changing worldwide. We retrospectively reviewed the data of 252 patients with suspected granulomatous lesions, seen over an 8-year period (2012–2020) at a tertiary care hospital with a voice clinic, in India. The epidemiological details, stroboscopy findings, histopathology, and response to treatment were noted. Some of the interesting cases with atypical presentations, which posed a diagnostic challenge, are discussed.

  1. Valente P, Ferreira J, Pinto I, et al. Management of laryngeal candidiasis: an evidence-based approach for the otolaryngologist. Eur Arch Otorhinolaryngol 2020;277(5):1267–1272. DOI: 10.1007/s00405-020-05865-4
  2. Dutta M, Jotdar A, Kundu S, et al. Primary laryngeal aspergillosis in the immunocompetent state: a clinical update. Braz J Otorhinolaryngol 2017;83(2):228–234. DOI: 10.1016/j.bjorl.2015.06.002
  3. Fisher EW, Richards A, Anderson G, et al. Laryngeal candidiasis: a cause of airway obstruction in the immunocompromised child. J Laryngol Otol 1992;106(2):168–170. DOI: 10.1017/s0022215100118997. PMID: 1532611.
  4. Beg MHA, Marfani S. The larynx in pulmonary tuberculosis. J Laryngol Otol 1985;99(2):201–203. DOI: 10.1017/s0022215100096547
  5. Uslu C, Oysu C, Uklumen B. Tuberculosis of the epiglottis: a case report. Eur Arch Otorhinolaryngol 2008;265(5):599–601. DOI: 10.1007/s00405-007-0492-9
  6. Nishiike S, Irigune M, Kubo T, et al. Laryngeal tuberculosis: a report of 15 cases. Ann Otol Rhinol Laryngol 2002;111(10):916–918. DOI: 10.1177/000348940211101010
  7. Galli J, Nardi C, Contucci AM,. Atypical isolated epiglottic tuberculosis: a case report and a review of the literatureet al. Am J Otolaryngol 2002;23(4):237–240. DOI: 10.1053/ajot.2002.123441
  8. Mehndiratta A, Bhat P, D'Costa L,. Primary tuberculosis of larynxet al. Indian J Tuberculosis 1997;44(4):211–212.
  9. Devine KD. Sarcoidosis and sarcoidosis of larynx. Laryngoscope 1965;75:533–569. DOI: 10.1288/00005537-196504000-00001
  10. Behnoud F, Baghbanian N. Isolated laryngeal amyloidosis. Iran J Otorhinolaryngol 2013;25(70):49–52.
  11. Almuslim HM, Alshaikh NA. Extensive laryngeal amyloidosis presenting with stridor: review of literature and case presentation. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2014;15(1):41–44.
  12. Daum TE, Specks U, Colby TV, et al. Tracheobronchial involvement in Wegener's granulomatosis. Am J Respir Crit Care Med 1995;151 (2 Pt 1):522–526. DOI: 10.1164/ajrccm.151.2.7842215
  13. Gluth MB, Shinners PA, Kasperbauer JL. Subglottic stenosis associated with Wegener's Granulomatosis. Laryngoscope 2003;113(8):1304–1307. DOI: 10.1097/00005537-200308000-00008
  14. O'Devaney K, Ferlito A, Hunter BC,. Wegener's granulomatosis of the head and necket al. Ann Otol Rhinol Laryngol 1998;107 (5 Pt 1):439–445. DOI: 10.1177/000348949810700515
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.