Herpetic lesions of the larynx

Herpetic lesions of the larynx are in the same category as lesions of the pharynx. For example, these diseases include the so-called summer flu (the name adopted in the USA), caused by Coxsackie viruses ( Herpangina ), which, along with lesions of other organs (epidemic pleurodynia, Coxsackie meningitis, Coxsackie myocarditis, vesicular stomatitis with skin manifestations, etc.), may also cause lesions of the upper respiratory tract, including the larynx. However, with Coxsackie herpangina, the larynx is not necessarily involved in the pathological process, while vulgar herpetic tonsillitis is very often accompanied by herpetic lesions of the mucous membrane of the larynx.

Simple herpes manifests itself in small vesicular group and single rashes on the mucous membrane of the oral cavity, soft palate, tonsils and vestibule of the larynx. When these vesicles burst, they leave behind round yellowish ulcers, and when they merge, they form larger superficial ulcers. Clinical manifestations of this type of herpetic lesion of the larynx include a burning sensation in the larynx, spontaneous pain radiating to the ear (otalgia), increasing with phonation and swallowing movements; increased body temperature, general weakness and malaise.

Herpetic lesions of the larynx should be differentiated from aphthous pharyngolaryngitis and manifestations of secondary syphilis, which are not characterized by vesicular eruptions.

Herpes zoster in the larynx is extremely rare. Vesicular eruptions always occur only on one side, without crossing the midline, and are located along the nerve fibers of the glossopharyngeal and vagus nerves. In some cases, this form of herpetic lesions of the larynx is associated with damage to the trigeminal, vestibulocochlear and facial nerves. A few days after the onset of the disease, the vesicles disappear, but unilateral paresis and paralysis of the larynx, pharynx, and signs of cochleovestibular dysfunction may persist - unilateral tinnitus and hearing loss of the perceptual type, spontaneous nystagmus and vertigo of peripheral genesis ("along the labyrinth").

Diagnosis is not difficult and is based on the symptom of a unilateral rash of herpetic vesicles.

Treatment of herpetic lesions of the larynx is no different from that described for Herpes zoster oticus or similar lesions of the pharynx. In neurological disorders, hyperdoses of vitamins B1 and B6, antihistamines are prescribed, and anti-edematous treatment is carried out, gamma globulin is administered.

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