Laryngites chroniques de l'adulte

Chronic laryngitis is a lingering inflammation of the laryngeal mucosa, usually lasting over two weeks. The specific aetiology of chronic laryngitis can include tuberculosis, herpes or sarcoidosis, etc. , however, its origin is often unknown. Specific forms of chronic laryngitis are not included in the present chapter since they are reviewed in the chapters on tuberculosis and other specific diseases. These non specific lesions have several aetiological and pathogenic factors; they present many different histological aspects, and their progression can take several forms including malignant development. The diversity of these characteristics accounts for the absence of codification of preventive and curative therapies. The role of the ENT specialist is to precisely identify such lesions using laryngeal video and/or laryngeal stroboscopic video. The examining physician should look for the most typical risk factors such as tobacco intoxication, ill-treatment of vocal chords or gastroesophageal reflux, in order to adapt preventive treatment. The endoscopic examination of laryngeal lesions using, whenever possible, autofluorescence, is essential in classifying the disease and in simultaneously defining suitable treatment. Within this context, the availability of laser techniques has enabled considerable improvement in the treatment of such lesions. The role of retinoids is limited and their prescription is often experience based. Finally, regular follow-up is essential since the malignant development of these precancerous lesions can be observed several years after initial diagnosis.