Mouse nibbled appearance of vocal cords is seen in:
Ref: Diseases of the Ear Nose and Throat by PL Dhingra .5th edn .2010 page. 312Explanation:TB LarynxTb larynx is almost secondary to pulmonary lbSeen mostly in middle aged malesBacilli reach the larynx by bronchogenic (via sputum) and hematogenous routeMost commonly posterior part of the larynx is affected i.e. arytenoids, inter arytenoids areaClinical FeaturesWeakness of voice (earliest symptom)Pain radiating to ear due to ulcerationOdynophagiaExamination FindingsMonocorditis - hyperemia of the vocal cord with impairment of adduction (earliest sign)Swelling in the inter arytenoids area giving it a niamiJated appearanceUlceration of the vocal cord - mouse nibbled appearanceUlceration and granulation over the arytenoids and inter arytenoid areaPsuedoedema of the epiglottis - Turban epiglottisPale mucosaSwelling of the false cord and aryepiglotticDiagnosis is by chest x-ray and sputum AFB examinationShould take a biopsy to rule out malignancy in suspected casesTreatment is with ATTLupusAffects the anterior part of larynxFirst epiglottis is affectedPainless and mostly asymptomaticGood prognosisTreatment is with ATTSyphilisCan affect any part any part of larynxLarynx generally affected in the tertiary stageDiagnosed with biopsy and serologyComplication - laryngeal stenosis
Tb larynx
Syphilis
Achalasia Cardia
Lupus
Infections and Inflammatory Conditions