Leprosy of the larynx and its clinical manifestations – A case report

Abstract

Objectives: To describe a case of a 48-year-old male, diagnosed and managed as a case of laryngeal leprosy. Study design: Case report. Results: A 48-year-old male sought consult due to a year-long history of progressive hoarseness and episodes of aspiration. The patient presented with leonine facies, saddle nose deformity, madarosis, accentuated skin folds, and hyperpigmented nodules with paresthesia on his extremities and trunk. Video laryngoscopy revealed enlarged and fixed arytenoids with an irregularly shaped mass extending to the false and true vocal folds, and a glottic opening of 2mm. He underwent prophylactic tracheostomy and direct laryngoscopy with biopsy and diagnostic esophagoscopy. Fiberoptic endoscopic evaluation of swallowing (FEES) confirmed aspiration and decreased laryngeal sensation. The tissue biopsy was consistent with laryngeal leprosy. The patient was started on multidrug therapy for leprosy. After three weeks of treatment, his lesions improved significantly. Further management included speech and swallowing therapy. A repeat FEES after three months of drug therapy was scheduled. Conclusion: Clinicians should be aware of the presentation and management of laryngeal leprosy despite its decreasing incidence in order to prevent complications and improve outcomes.

Keywords

• Multibacillary leprosy
• Mycobacterium leprae
• Laryngeal stenosis
• Lepromatous leprosy