DEPENDENCE OF CLINICAL MANIFESTATIONS ON THE LOCATION OF THE PATHOLOGICAL PROCESS IN LIMITED ORGANIC DISEASES OF THE LARYNX
DOI:
https://doi.org/10.37219/2443wx97Keywords:
larynx, vocal folds, organic pathology, dysphonia, endoscopic laryngoscopy, patient complaints, topical localizationAbstract
Background. Voice disorders (dysphonia) represent a widespread symptom that significantly reduces patients' quality of life and poses a threat of professional disability for individuals in voice-and-speech professions. In cases of limited organic laryngeal lesions, clinical manifestations do not always correspond to the scale of structural changes, which complicates the choice of treatment strategy and requires a thorough study of subjective symptoms.
Objective. To evaluate the nature of complaints, endoscopic features, and specific clinical manifestations of dysphonia in patients with small-volume organic laryngeal lesions.
Materials and Methods. A total of 78 patients with limited organic laryngeal pathology were examined. Based on endoscopic laryngoscopy findings (using "Karl Storz" and "XION" equipment, Germany), the nosological structure of the group was established as follows: vocal fold nodules – 39.0%, polyps – 21.0%, papillomatosis – 13.0%, granulomas – 9.0%, cysts – 8.0%, and fibromas – 4.0%. The comprehensive examination included history taking, systematization of complaints, and measurement of maximum phonation time (MPT).
Results. It was found that excessive vocal load was the primary anamnestic trigger for the development of pathology in the majority of patients, occurring against the background of concomitant inflammatory processes of the ENT organs, acute respiratory viral infections (ARVI), or psychoemotional stress. The evaluation of MPT across all nosologies revealed no specific features (results ranged within 14–18 s). The endoscopic picture expectedly differed by topography: nodules and polyps gravitated toward the medial edge of the vocal folds, granulomas toward the posterior regions, and papillomas toward the anterior commissure. The systematization of complaints demonstrated that the severity of dysphonia correlated not so much with the nosological form as with the anatomical location of the lesion.
Conclusions. Despite the diversity of nosologies, patients with small organic laryngeal lesions present uniform complaints of persistent hoarseness, discomfort, and vocal fatigue, regardless of the specific diagnosis. The degree of voice function degradation clearly depends on the topical localization of the lesion: more significant impairments are recorded when the pathological process involves the medial edge of the vocal folds (especially in the anterior commissure region), whereas the location of lesions in the posterior compartments of the larynx has a minor impact on voice quality.
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