Mouse-nibbled apperance of vocal cord is seen in: A . TB B . Syphillis C . Cancer D. Papilloma
Answer is A. Laryngeal TB a. Tuberculosis of larynx is always secondary to pulmonary TB. b. Tubercle bacilli reach the larynx by bronchogenic or haematogenous routes. c. Mostly affects males in middle age group. d. Affects posterior part of (Posterior Commissure) larynx more than anterior part. Clinical Features a. Weakness of voice (earliest symptom), odynophagia, dysphagia. b. Pain radiates to the ears. c. Laryngeal examination shows: *Vocal cord: Mouse nibbled ulceration * Arytenoids: show ulceration. * Interarytenoid region is swollen giving a mammillated appearance * Epiglottis shows: Pseudoedema and is called as 'turban epiglottis'. h. Surrounding mucosa is pale. Note Earliest sign = Adduction weakness Remember: Knob like epiglottis and Button hole Epiglottis is seen in leprosy
