Abstract
Isolated Fungal Laryngitis (FL) has recently shown an increased incidence globally and is now being reported even in immunocompetent individuals. In our Voice Clinic we have documented an increasing number of cases of FL, specifically laryngeal candidiasis, with the lesion over the striking zone (anterior 1/3rd posterior—2/3rd) of vocal folds. Our objective was to study the sites of involvement of FL within the glottis along with a review of literature. A 4 year retrospective study was performed by reviewing clinical and stroboscopic recordings of all patients diagnosed as FL at our Voice clinic. Age, gender, presenting complaints, co-morbidities, history of steroid intake orally or via inhalation and stroboscopic findings were noted as was response to antifungals and duration of treatment. A total of 55 cases were diagnosed with FL (all laryngeal candidiasis) between 2016 and 2019. Majority of them were immunocompetent, middle aged (41–60 years) males. Hoarseness was the most common presenting complaint. On stroboscopy, the striking zone involvement was seen in 89.1% cases. On comparing site of involvement a chi-square value of 115.58; p < 0.0001 was obtained. Complete resolution of the disease was observed after 3 weeks of oral Fluconazole in 65.5% patients while 27.3% needed treatment for 6 weeks and 7.2% did not improve necessitating excision of the lesion. Our study indicates the striking zone to be the most common site of involvement in patients with glottic FL. Statistical comparison between the sites of larynx affected revealed a p value < 0.0001.
Similar content being viewed by others
References
Klein AM, Tiu C, Lafreniere D (2005) Malignant mimickers: Chronic bacterial and fungal infections of the larynx. J Voice 19:151–157
Swain SK, Sahu MC, Debdta P, Baisakh MR (2019) Primary fungal laryngitis: An overlooked clinical entity. Apollo Medicine 16(1):11
Forrest LA, Weed H (1998) Candida laryngitis appearing asleukoplakia and gerd. J Voice 12(1):91–95
Dutta M, Jotdar A, Kundu S, Ghosh B, Mukhopadhyay S (2017) Primary laryngeal aspergillosis in the immunocompetent state: A clinical update. Braz J Otorhinolaryngol 83:228–234
Valente P, Ferreira J, Pinto I, Medeiros N, Oliveira P, Castro E, Condé A (2020) Management of laryngeal candidiasis: an evidence-based approach for the otolaryngologist. Eur Arch Otorhinolaryngol 27:1–6
Shoham S, Levitz SM (2005) The immune response to fungal infections. Br J Haematol 129(5):569–582
Henry LR, Packer MD, Brennan J (2005) Airway-obstructing laryngeal candidiasis in an immunocompetent host. Otolaryngol Head Neck Surg 133:808–810
Scheid Sara C, Anderson Timothy D, Sataloff Robert T (2003) Ulcerative fungal laryngitis. Laryngoscopic clinic Ear nose throat J 82:168
Ravikumar A, Kumar SP, Somu L, Sudhir B (2014) Fungal laryngitis in immunocompetent patients. Indian J Otolaryngol Head Neck Surg 66(1):375–378
Sulica L (2005) Laryngeal thrush. Ann Otol Rhinol Laryngol 114(5):369–375
Fisher EW, Richards A, Anderson G, Albert DM (1992) Laryngeal candidiasis: a cause of airway obstruction in the immunocompromised child. J Laryngol Otol 106(2):168–170
Andrade T, Correa D, León N, Napolitano C, Badía P (2016) Laringitis fúngica en pacientes inmunocompetentes. Revista de otorrinolaringología y cirugía de cabeza y cuello 76(1):7–14
Mehanna HM, Kuo T, Chaplin J, Taylor G, Morton RP (2004) Fungal laryngitis in immunocompetent patients. J Laryngol Otol 118(5):379–381
Chandran SK, Lyons KM, Divi V, Geyer M, Sataloff RT (2009) Fungal laryngitis. Ear Nose Throat J 88:1026–1027
Ogawa Y, Nishiyama N, Hagiwara A, Ami T, Fujita H, Yoshida T et al (2002) A case of laryngeal aspergillosis following radiation therapy. Auris Nasus Larynx 29:73–76
Nerurkar NK, Sapre AP, Gosavi RS (2017) Fungal Laryngitis in Immunocompetent Individuals: Not so Uncommon. Int J Phonosurg Laryngol 7(2):66–71
Wong KK, Pace-Asciak P, Wu B, Morrison MD 2009 Laryngeal candidiasis in the outpatient setting. Journal of Otolaryngology--Head & Neck Surgery. 38(6)
Chouksey S, Thulasidas P (2019) A Rare Case of Vocal Cord Aspergillosis. Indian J Otolaryngol Head Neck Surg 71(1):868–871
Pabuccuoglu U, Tuncer C, Sengiz S (2002) Histopathology of candidal hyperplastic lesions of the larynx. Pathol Res Pract 198:675–678
Kiakojuri K, Dehghan M, HasanjaniRoushan MR, Pourdadash B (2015) Candida laryngitis appearing as carcinoma. Caspian J Intern Med 6(4):248–250
Kameswaran M, Anand Kumar RS, Natarajan K et al (2006) laryngeal thrush: merf experience. Indian J Otolaryngol Head Neck Surg 58:329–31
Funding
The authors did not receive support from any organization for the submitted work.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they do not have any conflict of interest.
Ethics Approval
Approval was obtained from the ethics committee of Bombay Hospital & Medical Research Centre. The procedures used in this study adhere to the tenets of the Declaration of Helsinki (approval number- BH-EC-0042).
Consent to Participate
This is a retrospective study that received a consent waiver from the Ethics committee.
Consent for Publication
Yes.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Nerurkar, N.K., Agrawal, D. & Krishnan, R. A Four Year Retrospective Study of the Pattern of Fungal Laryngitis in a Tertiary Voice Care Centre. Indian J Otolaryngol Head Neck Surg 74, 463–468 (2022). https://doi.org/10.1007/s12070-021-02832-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-021-02832-1