Enfeksiyöz ve İnflamatuar Larinks Hastalıkları
Özet
Enfeksiyöz ve inflamatuar larinks hastalıkları kulak burun boğaz pratiğinde sık karşılaşılan ve geniş bir klinik spektrumda seyreden hastalıklardır. Klinik tablo hafif ses kısıklığından hayatı tehdit edebilen hava yolu obstrüksiyonuna kadar değişebilir. Larinks, çevresel irritanlara, enfeksiyöz ajanlara ve mekanik strese sürekli maruz kalması nedeniyle inflamasyona yatkın bir anatomik bölgedir. Bu bölümde akut ve kronik larenjitler, viral ve bakteriyel enfeksiyonlar, fungal larenjitler, tüberküloz larenjiti ve rekürren respiratuvar papillomatozis gibi enfeksiyöz hastalıklar ele alınmaktadır. Ayrıca Reinke ödemi, laringofaringeal reflü, alerjik larenjit ve krikoaritenoid artrit gibi inflamatuar patolojiler de ayrıntılı olarak incelenmektedir. Bu hastalıkların etiyolojik faktörleri, klinik bulguları, tanı yöntemleri ve güncel tedavi yaklaşımları literatür eşliğinde sunulmaktadır. Larinks hastalıklarının erken tanısı ve uygun tedavisi, hem hava yolu güvenliğinin sağlanması hem de ses fonksiyonunun korunması açısından büyük önem taşımaktadır.
Infectious and inflammatory diseases of the larynx are commonly encountered conditions in otolaryngology practice and may present with a wide spectrum of clinical manifestations. The clinical presentation may range from mild hoarseness to life-threatening airway obstruction. Due to its constant exposure to environmental irritants, infectious agents, and mechanical stress, the larynx is particularly susceptible to inflammatory processes. This chapter reviews major infectious conditions such as acute and chronic laryngitis, viral and bacterial infections, fungal laryngitis, laryngeal tuberculosis, and recurrent respiratory papillomatosis. In addition, inflammatory disorders including Reinke’s edema, laryngopharyngeal reflux, allergic laryngitis, and cricoarytenoid arthritis are discussed. The etiology, clinical manifestations, diagnostic approaches, and current treatment strategies of these conditions are presented in light of current literature. Early diagnosis and appropriate management of laryngeal diseases are essential for maintaining airway safety and preserving vocal function.
Referanslar
Gupta G, Mahajan K. Acute Laryngitis. 2022 Sep 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
Jaworek AJ, Earasi K, Lyons KM, et al. Acute infectious laryngitis: A case series. Ear Nose Throat Journal. 2018;97(9):306-313. doi: 10.1177/014556131809700920.
Caserta MT. Acute Laryngitis. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 2015:760–761.e1. doi: 10.1016/B978-1-4557-4801-3.00060-6.
Feng W, Chen H, Lu Y, et al. Comparing the efficacy and safety of atomization of traditional Chinese medicine Kai Hou Jian and budesonide suspension in adult acute laryngitis: a randomized control trial. Annals of Translational Medicine. 2022;10(18):1019. doi: 10.21037/atm-22-4305.
Zhu Y, Sun X, Liu G. Characteristics influencing acute laryngitis and laryngeal obstruction in children: A retrospective study. Medicine (Baltimore). 2024;103(52):e40885. doi: 10.1097/MD.0000000000040885.
Añón-Hidalgo J, Trincado-Lamuño R, Esparza-Isasa E, et al. Acute laryngitis in a paediatric emergency department before and after the COVID-19 pandemic. Has anything changed? Anales de Pediatria. 2024;100(1):57-59. doi: 10.1016/j.anpede.2023.11.011.
Carpenter PS, Kendall KA. MRSA chronic bacterial laryngitis: A growing problem. Laryngoscope. 2018;128(4):921-925. doi: 10.1002/lary.26955.
Jetté M. Toward an Understanding of the Pathophysiology of Chronic Laryngitis. Perspect ASHA Special Interest Groups. 2016;1(3):14-25. doi: 10.1044/persp1.sig3.14.
Conti KR, Zhao A, Hunt E, et al. Practical Application of Culture-Directed Treatment for Chronic Bacterial Laryngitis. Laryngoscope. 2024;134(1):335-339. doi: 10.1002/lary.30906.
Eckley CA, Tangerina R. Using RSI and RFS scores to differentiate between reflux-related and other causes of chronic laryngitis. The Brazilian Journal of Otorhinolaryngology. 2023;89(1):54-59. doi: 10.1016/j.bjorl.2021.08.003.
Toyoshima H, Yamada H, Tanigawa M, et al. Chronic Bacterial Laryngitis: A Diagnostic Pitfall for Clinicians. Internal Medicine. 2022;61(4):597-598. doi: 10.2169/internalmedicine.7796-21.
Yang Y, Wu H, Zhou J. Efficacy of acid suppression therapy in gastroesophageal reflux disease-related chronic laryngitis. Medicine (Baltimore). 2016;95(40):e4868. doi: 10.1097/MD.0000000000004868.
Rubin F, Jameleddine E, Guiquerro S, et al. Laryngeal tuberculosis in the early 21st century. Literature review of clinical, diagnostic and therapeutic data, according to SWiM guidelines. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2024;141(3):147-152. doi: 10.1016/j.anorl.2024.01.001.
Nerurkar NK, Jahnavi. Laryngeal Tuberculosis: Current Patterns of Presentation and Management. Indian Journal of Otolaryngology and Head Neck Surgery. 2024;76(1):904-909. doi: 10.1007/s12070-023-04316-w.
Pandiyan H, Sivanand N, Sathish Kumar S. Isolated Laryngeal Tuberculosis: a Diagnostic Dilemma. Indian Journal of Otolaryngology and Head Neck Surgery. 2022;74(Suppl 2):2308-2310. doi: 10.1007/s12070-020-02139-7
Agarwal R, Gupta L, Singh M, et al. Primary Laryngeal Tuberculosis: A Series of 15 Cases. Head and Neck Pathology. 2019;13(3):339-343. doi: 10.1007/s12105-018-0970-y.
Mouhsine A, Belkouch A, Temsamani H, et al. Laryngeal tuberculosis: about 04 cases. Pan African Medical Journal. 2023 31;45:193. doi: 10.11604/pamj.2023.45.193.5325.
Jindal SK, Jindal A, Agarwal R. Upper Respiratory Tract Tuberculosis. Microbiology Spectrum. 2016;4(6). doi: 10.1128/microbiolspec.TNMI7-0009-2016.
Bouatay R, Bouaziz N, Abdallah H, et al. Isolated laryngeal tuberculosis: A diagnostic dilemma. International Journal of Surgery Case Reports. 2024;116:109376. doi: 10.1016/j.ijscr.2024.109376.
Thomas N, Nambiar SS, Nampoothiri PM. Extrapulmonary Tuberculosis: An Otorhinolaryngologist's Perspective. Indian Journal of Otolaryngology and Head Neck Surgery. 2022;74(Suppl 3):5562-5568. doi: 10.1007/s12070-021-02903-3.
Raj R, Sud P, Saharan N, et al. Laryngeal tuberculosis: a neglected diagnosis. BMJ Case Reports. 2022;15(2):e248095. doi: 10.1136/bcr-2021-248095.
Nerurkar NK, Agrawal D, Krishnan R. A Four Year Retrospective Study of the Pattern of Fungal Laryngitis in a Tertiary Voice Care Centre. Indian Journal of Otolaryngology and Head Neck Surgery. 2022;74(4):463-468. doi: 10.1007/s12070-021-02832-1.
Sheth MC, Paul RR, Mathews SS, et al. Isolated Aspergillus Laryngitis: Spectrum, Management, and Review of Literature. Journal of Voice. 2022;36(6):880.e13-880.e19. doi: 10.1016/j.jvoice.2020.09.009.
Oliveira VF, Taborda M, Catarina MBS, et al. Clinical and immunological features of laryngeal cryptococcosis. Revista do Instituto de Medicina Tropical de Sao Paulo. 2024;66:e40. doi: 10.1590/S1678-9946202466040.
Thomas RA, Kew TY, Mat Baki M. Primary fungal laryngitis mimicking recurrent laryngeal carcinoma. BMJ Case Reports. 2022;15(2):e245678. doi: 10.1136/bcr-2021-245678.
Winters JR, Manosalva RE, Morrison MP. Laryngeal Cryptococcal Infection. Ear Nose Throat Journal. 2020;99(1):13-14. doi: 10.1177/0145561319836808.
Chauhan N, Robinson JL, Guillemaud J, et al. Acute herpes simplex laryngotracheitis: Report of two pediatric cases and review of the literature. International Journal of Pediatric Otorhinolaryngology. 2007;71(2):341-5. doi: 10.1016/j.ijporl.2006.10.012.
Boyd TW, Patil SM, Sinclair J, et al. Acute Herpes Simplex Virus Laryngitis Presenting as Airway Obstruction Post Influenza: A Viral Pneumonia. Cureus. 2023;15(9):e45742. doi: 10.7759/cureus.45742.
Bowers EMR, Esianor BI, Kimura K, et al. Disseminated Herpes Simplex Infection Presenting as Acute Supraglottitis in an Adult. Head and Neck Pathology. 2021;15(3):1074-1081. doi: 10.1007/s12105-020-01255-8.
Bachrach K, Levi JR, Tracy LF. Herpes simplex laryngitis: Comparison between pediatric and adult patients. International Journal of Pediatric Otorhinolaryngology. 2021;142:110596. doi: 10.1016/j.ijporl.2020.110596.
Sims JR, Massoll NA, Suen JY. Herpes simplex infection of the larynx requiring laryngectomy. American Journal of Otolaryngology. 2013;34(3):236-8. doi: 10.1016/j.amjoto.2012.11.006.
Park JM, Kim SE, Yang HC. Clinical characteristics of herpes zoster laryngitis. European Archives of Otorhinolaryngology. 2020;277(10):2907-2912. doi: 10.1007/s00405-020-06074-9.
Cheng L, Lin Y, Yang J, et al. Clinical Characteristics and Prognosis of Herpes Zoster Laryngitis With Vocal Fold Immobility. Journal of Voice. 2024:S0892-1997(24)00172-3. doi: 10.1016/j.jvoice.2024.05.020.
Watelet JB, Evrard AS, Lawson G, et al. Herpes zoster laryngitis: case report and serological profile. European Archives of Otorhinolaryngology. 2007;264(5):505-7. doi: 10.1007/s00405-006-0207-7.
Swain SK, Acharya S, Shajahan N, et al. Herpes zoster laryngitis. Journal of Scientific Society. 2020;47:45 7. doi:10.4103/jss.JSS_10_20.
Maïga S, Ndiaye C, Diouf M, et al. Laryngeal papillomatosis in Senegal: A ten-year experience. European Annals of Otorhinolaryngology Head and Neck Diseases. 2018;135(3):221-224. doi: 10.1016/j.anorl.2018.01.002.
Coordes A, Grund D, Mainka A, et al. Rezidivierende Larynxpapillomatose [Recurrent laryngeal papillomatosis]. HNO. 2023;71(2):77-82. German. doi: 10.1007/s00106-022-01250-1.
Fortes HR, von Ranke FM, Escuissato DL, et al. Recurrent respiratory papillomatosis: A state-of-the-art review. Respiratory Medicine. 2017;126:116-121. doi: 10.1016/j.rmed.2017.03.030.
Levinson J, Karle WE. Laryngeal Papillomatosis. Cancers (Basel). 202510;17(6):929. doi: 10.3390/cancers17060929.
Eslami H, Tohidi R, Ranjbar FE, et al. Reinke's Edema and Risk Factors, A Case-Control Study. Indian Journal of Otolaryngology and Head Neck Surgery. 2024;76(2):1819-1824. doi: 10.1007/s12070-023-04418-5.
Dewan K, Chhetri DK, Hoffman H. Reinke's edema management and voice outcomes. Laryngoscope Investigative Otolaryngology. 2022;7(4):1042-1050. doi: 10.1002/lio2.840.
Grigaliute E, Fiamingo MN, Albanese PG, et al. Phonosurgery of Reinke's edema with microdebrider. European Archives of Otorhinolaryngology. 2022;279(8):4053-4059. doi: 10.1007/s00405-022-07377-9.
Longo L, Pipitone LL, Cilfone A, et al. Reinke's Edema: New Insights into Voice Analysis, a Retrospective Study. Journal of Voice. 2026;40(1):256.e9-256.e18. doi: 10.1016/j.jvoice.2023.08.008.
Chai VZ, Ramadan O, Sataloff RT. Severe Reinke's Edema. Ear Nose Throat Journal. 2024:1455613241252535. doi: 10.1177/01455613241252535.
Barmak E, Altan E, Yılmaz Z, et al. Impact of the Severity of Reinke's Edema on the Parameters of Voice. Turkish Archives of Otorhinolaryngology. 2023;61(4):166-174. doi: 10.4274/tao.2023.2023-8-10.
Arokoyo OM, Adeleye CT, Hyacinth WU, et al. Reinke's Oedema in Africa: A Scoping Review. Cureus. 2025;17(2):e78931. doi: 10.7759/cureus.78931.
Lechien JR, Saussez S, Harmegnies B, et al. Laryngopharyngeal Reflux and Voice Disorders: A Multifactorial Model of Etiology and Pathophysiology. Journal of Voice. 2017;31(6):733-752. doi: 10.1016/j.jvoice.2017.03.015.
Barham WT, Alvarez-Amado AV, Dillman KM, et al. Laryngopharyngeal Reflux Pathophysiology, Clinical Presentation, and Management: A Narrative Review. Cureus. 2024;16(8):e67305. doi: 10.7759/cureus.67305.
Lien HC, Lee PH, Wang CC. Diagnosis of Laryngopharyngeal Reflux: Past, Present, and Future-A Mini-Review. Diagnostics (Basel). 2023;13(9):1643. doi: 10.3390/diagnostics13091643.
Cui N, Dai T, Liu Y, et al. Laryngopharyngeal reflux disease: Updated examination of mechanisms, pathophysiology, treatment, and association with gastroesophageal reflux disease. World Journal of Gastroenterology. 2024;30(16):2209-2219. doi: 10.3748/wjg.v30.i16.2209.
Krause AJ, Yadlapati R. Review article: Diagnosis and management of laryngopharyngeal reflux. Alimentary Pharmacology Therapeutics. 2024;59(5):616-631. doi: 10.1111/apt.17858.
Krause AJ, Walsh EH, Weissbrod PA, et al. An update on current treatment strategies for laryngopharyngeal reflux symptoms. Annals of New York Academy of Sciences. 2022;1510(1):5-17. doi: 10.1111/nyas.14728.
Campagnolo A, Benninger MS. Allergic laryngitis: chronic laryngitis and allergic sensitization. Brazilian Journal of Otorhinolaryngology. 2019;85(3):263-266. doi: 10.1016/j.bjorl.2019.02.001.
Naito K, Kato H, Inuzuka Y, et al. Laryngeal allergy. Fujita Medical Journal. 2021;7(3):71-75. doi: 10.20407/fmj.2020-022.
Hamdan AL, Abi Zeid Daou C, Karam M. Prevalence of Allergy in Patients with Primary Dysphonia. Indian Journal of Otolaryngology and Head Neck Surgery. 2023;75(2):692-696. doi: 10.1007/s12070-022-03403-8.
Leedman SR, Hendriks T, Leahy TW, et al. Supraglottic laryngeal sarcoidosis masquerading as supraglottitis. BMJ Case Reports. 2020;13(1):e232369. doi: 10.1136/bcr-2019-232369.
Lovell L, Clunie GM, Al-Yaghchi C, et al. Laryngeal Sarcoidosis and Swallowing: What Do We Know About Dysphagia Assessment and Management in this Population? Dysphagia. 2022;37(3):548-557. doi: 10.1007/s00455-021-10305-4.
Besharah BO, Mujahed RA, AlKaf HH, et al. Uncommon presentation of isolated laryngeal sarcoidosis in a young man. Annals of Medicine and Surgery. 2022;80:104216. doi: 10.1016/j.amsu.2022.104216.
Ahmadi A, Dehghani Firouzabadi F, Dehghani Firouzabadi M, et al. Isolated laryngeal sarcoidosis. Respirology Case Reports. 2019;8(1):e00502. doi: 10.1002/rcr2.502.
Edriss H, Kelley J, Demke J. Sinonasal and laryngeal sarcoidosis. Baylor University Medical Center Proceedings. 2017;30(4):452-454. doi: 10.1080/08998280.2017.11930226.
Trimarchi M, Sinico RA, Teggi R, et al. Otorhinolaryngological manifestations in granulomatosis with polyangiitis (Wegener's). Autoimmunity Reviews. 2013;12(4):501-5. doi: 10.1016/j.autrev.2012.08.010.
Burrascano D, Verro B, Ottoveggio G, et al. Laryngeal Frame Involvement as The First Sign of Wegener's Granulomatosis. Iranian Journal of Otorhinolaryngology. 2025;37(2):95-98. doi: 10.22038/ijorl.2024.81617.3746.
Lee PY, Adil EA, Irace AL, et al. The presentation and management of granulomatosis with polyangiitis (Wegener's Granulomatosis) in the pediatric airway. Laryngoscope. 2017;127(1):233-240. doi: 10.1002/lary.26013.
Lazzari G, Briatico Vangosa A, De Cillis MA, et al. Radiotherapy in advanced glottic laryngeal carcinoma in a patient with Wegener's granulomatosis: how much radiation dose is needed? Onco Targets and Therapy. 2019;12:753-757. doi: 10.2147/OTT.S182011.
Farah C, Tabesh OA, Okais J, et al. Cricoarytenoid joint arthritis: a possible complication of dermatomyositis. Pan African Medical Journal. 2020;36:74. doi: 10.11604/pamj.2020.36.74.18891.
Kunieda C, Mori T, Konomi U, et al. Ultrasonography of the cricoarytenoid joint and its movements. Auris Nasus Larynx. 2024;51(6):1068-1072. doi: 10.1016/j.anl.2024.10.001.
Pradhan P, Bhardwaj A, Venkatachalam VP. Bilateral Cricoarytenoid Arthritis: A Cause of Recurrent Upper Airway Obstruction in Rheumatoid Arthritis. The Malaysian Journal of Medical Sciences. 2016;23(3):89-91.
Hyland LD, Saville R, Dwiddar N, et al. Bilateral Vocal Cord Palsy Secondary to Rheumatoid Arthritis. Cureus. 2024;16(1):e51958. doi: 10.7759/cureus.51958.
Hamdan AL, Khalifee E, Berjawi G. Unilateral Cricoarytenoid Joint Ankylosis in Rheumatoid Arthritis. Ear Nose Throat Journal. 2020;99(1):11-12. doi: 10.1177/0145561319825734.
