Sunday, 22 December 2013

Laryngeal pseudosulcus

Laryngeal pseudosulcus is subglottic edema seen in some new borns.
Laryngeal pseudosulcus is d/t------- reflux induced laryngitis (pharyngoesophageal reflux) in the pediatric patients.
Edema along the undersurface of the vocal fold from the anterior to the posterior commissure
It is a common endoscopic finding of EER (extraesophageal reflux).
By contrast, true sulcus vocalis involves the free edge of the fold and terminates at the vocal process.
Major laryngeal findings in chronic laryngitis associated with EER are seen in the posterior larynx.
Posterior laryngitis is manifested by edema, increased vascularity and erythema of the posterior commissure, and arytenoids.
Chronic irritation can result in a thickening of the posterior laryngeal mucosa with hyperkeratosis, which is also called pachydermia laryngeus. This posterior mucosal thickening with increased granularity and rough cobblestone appearance is described as “granular mucositis.”
Increased mucus formation and thickness, along with mucus stranding and pooling, may result from chronic irritation and alterations of mucociliary flow. Laryngeal ulceration, granuloma formation, scarring, and stenosis may indicate more severe EER.
Erythema of the posterior larynx is the most prevalent sign
Erythema of posterior larynx----- sign which is most reversible with treatment of EER.
More severe inflammation or longer duration of symptoms is associated with increasing vascularity and erythema extending into the remainder of the larynx and supraglottis. Posterior glottic mucosal thickening is the second most common findings.

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