TB larynx most commonly affect:

Ans: a (Posterior commissure) Ref: Scott Brown, 7th ed, p. 2266Etiology: Secondary to pulmonary tuberculosisSite: Posterior part affected more than anteriorInterarytenoid fold > Ventricular bands> Vocal cords >EpiglottisC/F:Earliest symptom--weakness of voice followed by hoarsenessEarliest sign--Impaired adduction.Laryngeal findings:Impaired adductionMammillated appearance - due to swelling in inter arytenoid regionMouse nibbled appearance - due to ulceration of vocal cordTurban epiglottis - due to pseudoedema of epiglottisMarked pallor of surrounding mucosaRagged ulceration and granulomas of arytenoids and interarytenoid region.Inv: Biopsy of laryngeal lesion, CXR, sputum for AFBTreatment: ATT+voice restOther laryngeal lesion & sites of involvement:* Lupus-Anterior > posterior (epiglottis is involved)* Syphilitic-Any part of larynx* Laryngeal web-Between the vocal cords* Vocal nodule-B/L at junction of anterior l/3rd and post 2/3rd of vocal cords* Vocal polyp-U/L at junction of anterior l/3rd and post 2/3rdof vocal cords.* Reinke's edema-Symmetrical edema of both vocal cords* Contact ulcer-Vocal processes of arytenoids* Laryngocele-Through thyrohyoid membrane (dilatation of saccule)* Intubation granuloma-B/L involving posterior l/3rd of vocal cords.