Laryngeal manifestations of connective tissue diseases

Background: Connective Tissue Diseases (CTD) are common and can lead to significant voice impairment. Bamboo nodules, vocal fold (VF) edema and erythema, viscous secretions, and globus are also reported laryngeal findings with CTDs.Objective: To identify the effect of connective tissue diseases on the laryngeal structure and vocal function.Patients and methods: 60 patients with CTD were divided into three groups: 36 with rheumatoid arthritis (RA), 10 with systemic lupus erythematous (SLE), and 14 with other CTDs. Auditory perceptual assessment (APA), Laryngoscopic examination, Voice handicap index (VHI) and acoustic analysis were done for all patients.Results: The common laryngeal findings were vocal fold redness (73%), followed by vocal fold edema (57%), both arytenoid congestion and edema (55%), intra-arytenoid granulation (43.3%), phonatory gap (41%), bamboo nodules (15%) and unilateral ventricular fold hypertrophy (13.3%). Patients with RA had a higher incidence of vocal fold redness (63.9%) and arytenoid congestion (75%) compared to patients with SLE who had a higher incidence of vocal fold edema and phonatory gap. There was a correlation between the type of CTD and the presence of various vocal fold lesions. Conclusion: Patients with RA were found to have a higher incidence of VF redness and arytenoid congestion, while patients with SLE had a higher incidence of VF edema and phonatory gap. Further studies with larger sample sizes are needed to confirm these findings and to clarify the relationship between CTD and laryngeal manifestations.