Acute laryngitis superimposed on chronic laryngitis

February 25, 2013
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Laryngoscopic Clinic

Radiation-induced fibrosis can be found in tissues of the neck, pharynx, larynx, esophagus, ear, and temporomandibular joint. It is associated histologically with aggregates of macrophages, fibroblasts, vascular connective tissue changes, and deposition of extracellular matrix. This fibrosis can lead to strictures, stenosis, trismus, ulcerations, and scarring, which can present as dysphagia and dysphonia.

A 40-year-old man with a remote history of head and neck radiation for Hodgkin lymphoma presented with dysphonia, voice fatigue, and productive cough of 1 week's duration. Strobovideolaryngoscopy revealed diffuse erythema, increased mucus viscosity, bilateral vocal fold varicosities, and bilateral vocal fold stiffness and scars. His symptoms and examination findings suggested acute laryngitis superimposed on chronic radiation laryngitis (figures 1 and 2).

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