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Chronic non-granulomatous supraglottitis: a rare and difficult disease

Published online by Cambridge University Press:  29 May 2012

L G Ledgerwood
Affiliation:
Center for Voice and Swallowing, University of California, Sacramento, USA
P C Belafsky*
Affiliation:
Center for Voice and Swallowing, University of California, Sacramento, USA
*
Address for correspondence: Dr Peter C Belafsky, Center for Voice and Swallowing, University of California, Davis, 2521 Stockton Blvd, Suite 7200, Sacramento, CA 95817, USA Fax: +1 916 703 5011 E-mail: peterb@ucdvoice.org

Abstract

Objectives:

To examine chronic non-granulomatous supraglottitis, a rare disorder of uncertain aetiology with few reported cases in the literature.

Case reports:

We describe two cases of chronic non-granulomatous supraglottitis that led to persistent respiratory compromise. Patients underwent extensive investigation that failed to reveal a definitive diagnosis.

Conclusion:

In patients suffering from chronic inflammation of the supraglottic larynx without evidence of infection, neoplasm or granulomatous disease, many disorders must be ruled out in order to diagnose chronic non-granulomatous supraglottitis, which is a diagnosis of exclusion. We review the literature on this rare entity, discuss current management strategies, and suggest an algorithm for diagnostic investigation.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented as a poster at the American Laryngological Association as part of the Combined Otolaryngological Spring Meetings, 27–28 April 2011, Chicago, Illinois, USA

References

1 Franco, RA Jr. Laryngopharyngeal reflux. Allergy Asthma Proc 2006;27:21–5Google ScholarPubMed
2 Marcotullio, D, Magliulo, G, Pezone, T. Reinke's edema and risk factors: clinical and histopathologic aspects. Am J Otolaryngol 2002;23:81–4CrossRefGoogle ScholarPubMed
3 Kravos, A, Zupevc, A, Cizmarevic, B, Hocevar-Boltezar, I. The role of allergy in the etiology of Reinke's edema on vocal folds. Wien Klin Wochenschr 2010;122(suppl 2):44–8CrossRefGoogle ScholarPubMed
4 Parab, SR, Khan, MM, Ghaisas, VS. Simultaneous involvement of larynx and middle ear in pulmonary tuberculosis. Laryngoscope 2010;120:1892–4CrossRefGoogle ScholarPubMed
5 Brass, LS, White, JA. Granulomatous disease of the larynx. J La State Med Soc 1991;143:1114 Google ScholarPubMed
6 Pace, JL, Csonka, GW. Late endemic syphilis: case report of bejel with gummatous laryngitis. Genitourin Med 1988;64:202–4Google ScholarPubMed
7 Pochini Sobrinho, F, Della Negra, M, Queiroz, W, Ribeiro, UJ, Bittencourt, S, Klautau, GB. Histoplasmosis of the larynx. Braz J Otorhinolaryngol 2007;73:857–61CrossRefGoogle ScholarPubMed
8 Miller, R, Myer, CM 3rd, Gray, S. Otolaryngologic manifestations of chronic granulomatous disease. Am J Otolaryngol 1988;9:7982 CrossRefGoogle ScholarPubMed
9 Musharrafieh, UM, Araj, GF, Fuleihan, NS. Viral supraglottitis in an adult: a case presentation and literature update. J Infect 1999;39:157–60CrossRefGoogle Scholar
10 Eliachar, I, Lichtig, C. Local amyloid deposits of the larynx. Electron microscopic studies of three cases. Arch Otolaryngol 1970;92:163–6CrossRefGoogle ScholarPubMed
11 Hazenberg, AJ, Dikkers, FG, Hawkins, PN, Bijzet, J, Rowczenio, D, Gilbertson, J et al. Laryngeal presentation of systemic apolipoprotein A-I-derived amyloidosis. Laryngoscope 2009;119:608–15CrossRefGoogle ScholarPubMed
12 Talerman, A, Wright, D. Laryngeal obstruction due to Wegener's granulomatosis. Arch Otolaryngol 1972;96:376–9CrossRefGoogle ScholarPubMed
13 Letko, E, Zafirakis, P, Baltatzis, S, Voudouri, A, Livir-Rallatos, C, Foster, CS. Relapsing polychondritis: a clinical review. Semin Arthritis Rheum 2002;31:384–95CrossRefGoogle ScholarPubMed
14 Haar, JG, Chaudhry, AP, Kaplan, HM, Milley, PS. Granulomatous laryngitis of unknown etiology. Laryngoscope 1980;90:1225–9CrossRefGoogle ScholarPubMed
15 Scarpelli, DG, McCoy, FW, Scott, JK. Acute lupus erythematosus with laryngeal involvement. N Engl J Med 1959;261:691–4CrossRefGoogle ScholarPubMed
16 Markovic, SN, Inwards, DJ, Frigas, EA, Phyliky, RP. Acquired C1 esterase inhibitor deficiency. Ann Intern Med 2000;132:144–50CrossRefGoogle ScholarPubMed
17 Small, P, Frenkiel, S. Hereditary angioneurotic edema first observed as an epiglottiditis. Arch Otolaryngol 1983;109:195–6CrossRefGoogle ScholarPubMed
18 Wong, DT, Gadsden, JC. Acute upper airway angioedema secondary to acquired C1 esterase inhibitor deficiency: a case report. Can J Anaesth 2003;50:900–3CrossRefGoogle ScholarPubMed
19 Friedman, M, Toriumi, DM, Strorigl, T. Chronic nongranulomatous epiglottitis. Ear Nose Throat J 1988;67:524–7Google ScholarPubMed
20 Schrottenbaum, M. Unusual chronic epiglottis inflammation [in German]. Zentralbl Allg Pathol 1963;104:255–7Google ScholarPubMed
21 Caldarelli, DD, Friedberg, SA, Harris, AA. Medical and surgical aspects of the granulomatous diseases of the larynx. Otolaryngol Clin North Am 1979;12:767–81CrossRefGoogle ScholarPubMed
22 Parsons, DS, Smith, RB, Mair, EA, Dlabal, LJ. Unique case presentations of acute epiglottic swelling and a protocol for acute airway compromise. Laryngoscope 1996;106:1287–91CrossRefGoogle Scholar
23 Sharma, N, Berman, DM, Scott, GB, Josephson, G. Candida epiglottitis in an adolescent with acquired immunodeficiency syndrome. Pediatr Infect Dis J 2005;24:91–2CrossRefGoogle Scholar
24 Wilson, JF, Coutras, S, Tami, TA. Recurrent adult acute epiglottitis: the role of lingual tonsillectomy. Ann Otol Rhinol Laryngol 1989;98:602–4CrossRefGoogle ScholarPubMed
25 Rosenfeld, RM, Biller, HF. Chronic nongranulomatous epiglottitis. Ear Nose Throat J 1989;68:265 Google ScholarPubMed
26 Hirshoren, N, Eliashar, R, Weinberger, JM. Hydroxychloroquine for subglottic stenosis: a novel therapy in the battle for air. Laryngoscope 2010;120:743–4CrossRefGoogle ScholarPubMed
27 Kalia, S, Dutz, JP. New concepts in antimalarial use and mode of action in dermatology. Dermatol Ther 2007;20:160–74CrossRefGoogle ScholarPubMed