EpistemisLaryngodynia
Specialty: Otolaryngology.
Why it occurs
- Traumatic or autoimmune chondritis or perichondritis of the laryngeal cartilages (thyroid, cricoid, arytenoid)
- De Quervain's subacute thyroiditis (due to anatomical vicinity of the thyroid gland)
- Closed external laryngeal trauma with cartilage fracture or dislocation
- Arthritis of the cricoarytenoid joint associated with rheumatoid arthritis
- Malignant infiltrating supraglottic or transglottic tumor with invasion of the laryngeal cartilaginous skeleton
Initial workup
Systematic external palpation of the larynx to look for elective pain points, preserved transverse laryngotracheal mobility (Moure's sign or laryngeal crunch), flexible nasofibrolaryngoscopy, high-resolution contrast-enhanced CT of the larynx, and blood tests with erythrocyte sedimentation rate (ESR), CRP, and thyroid hormones (TSH, free T4).
red flags
Inspiratory dyspnea of rapid evolution, audible stridor, frank hemoptysis, severe dysphagia with odynophagia that prevents swallowing saliva, accelerated weight loss, blown voice or persistent dysphonia of sudden onset, or palpable external deformity of the normal laryngeal contour.
Standard management
- Non-steroidal anti-inflammatories such as dexketoprofen — 25 mg every 8 hours orally) or meloxicam (15 mg orally every 24 hours, limiting its use if there is cardiovascular or renal risk
- Systemic corticosteroids such as prednisone if active perichondritis of non-infectious origin is confirmed
- Systemic antibiotics if there is suspicious bacterial infectious chondritis.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Otolaryngology
- Listed causes
- 5
- Treatment options
- 3