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I really do not know what this disorder is caused by or what is the appropriate treatment. I have seen several patients with similar larynges. They have a dryness and crusting that can be irrigated off. Biopsies are negative for cancer or autoimmune disease. They have responded temporarily to steroids (prednisone or medrol). They have not responded to antireflux treatment. |
Patient #1 |
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30 year old female with hoarseness, previously treated with prilosec and no improvement. This photo is after gargling with saline each day. Biopsy is negative for cancer. |
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after treatment with nystatin |
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after treatment with saline rinses and Tetracycline |
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pregnant, on guiafenesin, prilosec and saline gargles |
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pregnant, on guiafenesin and Zantac |
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symptoms worse with another pregnancy, on Prednisone 10 mg per day for several months. She had tried Methotrexate for awhile without improvement. |
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phone call to patient: symptoms still present 7 years after last visit |
Patient #2 |
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45 year old female with 6 years of hoarseness. symptoms of heartburn. Already treated for reflux with improvement in heartburn, but not improvement in voice. She is on prednisone, presently at 20 mg, down from 120 mg. albuteral, alupent, Advair, Atrovent inhalers, nexium, reglan and singulair. A biopsy was negative for cancer. |
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stroboscopic view during open phase of vibration |
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pre-phonation position of vocal cords |
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More prednisone no benefit, still hoarse |
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coughing a lot despite prednisone and Dicloxacillin (view of posterior larynx) |
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coughing a lot despite prednisone and Dicloxacillin (closer view) |
Patient #3 |
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37 yo male with 8 years of hoarseness. He is being treated with Flonase, Zantac and allergy shots with no improvement.
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Closer view. Abduction. Biopsy recommended, but not performed. |
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Closer view. Adduction. |
Patient #4 |
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34 yo male with 4 months of hoarseness. He smokes 1 pack per day of tobacco for 15 years. 2 biopsies are negative for cancer, only inflammation. |
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Closer view. |
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