Common Diseases of the Mouth, Pharynx, and Larynx

Posted on Jan 13, 2026 in Medicine & Health

Stomatitis

Definition

  • Inflammation of the oral mucosa, which may involve the cheeks, gums, tongue, lips, and roof or floor of the mouth.

Etiology

  • Infectious: viral (e.g., *HSV*), bacterial, fungal (e.g., *candidiasis*).
  • Non-infectious: aphthous ulcers, trauma, nutritional deficiencies (B12, iron, folate), autoimmune diseases (e.g., *lichen planus*).
  • Irritants: poor oral hygiene, smoking, alcohol, spicy foods, certain medications (e.g., chemotherapy).

Clinical Features

  • Painful oral ulcers or erythema.
  • Swelling, burning sensation, difficulty eating or speaking.
  • May be associated with fever, bad breath, or lymphadenopathy in infectious cases.

Diagnosis

  • Clinical examination of the oral cavity.
  • Swabs for culture or PCR (if infection suspected).
  • Blood tests for nutritional deficiencies or autoimmune screening if indicated.

Treatment

  • Address underlying cause (antivirals, antifungals, antibiotics, or supplementation).
  • Maintain good oral hygiene.
  • Topical treatments: analgesics, corticosteroids, antiseptic mouthwashes.

Acute and Chronic Pharyngitis

Definition

  • Acute pharyngitis: Sudden onset inflammation of the pharyngeal mucosa.
  • Chronic pharyngitis: Persistent or recurrent inflammation of the pharynx lasting more than a few weeks.

Etiology

  • Acute: Viral (most common – adenovirus, rhinovirus), bacterial (e.g., *Group A Streptococcus*), fungal in immunocompromised patients.
  • Chronic: Repeated infections, smoking, alcohol, air pollution, mouth breathing, GERD, chronic tonsillitis.

Clinical Features

  • Acute: Sore throat, fever, dysphagia, erythematous pharynx, tonsillar exudates (in bacterial cases).
  • Chronic: Persistent throat discomfort, dry throat, frequent throat clearing, foreign body sensation.
  • May have associated cough or hoarseness.

Diagnosis

  • Clinical examination and history.
  • Throat swab and culture or rapid antigen test for streptococcal pharyngitis.
  • Laryngoscopy in chronic cases to rule out other causes.

Treatment

  • Acute: Supportive care (analgesics, fluids); antibiotics if bacterial (e.g., penicillin for strep).
  • Chronic: Treat underlying cause (e.g., GERD, environmental irritants), voice hygiene, humidification.
  • Avoid irritants (smoking, alcohol), ensure proper hydration.

Tumors of the Pharynx

Definition

  • Benign or malignant neoplasms arising from the mucosa of the pharynx (nasopharynx, oropharynx, hypopharynx).

Etiology

  • Risk factors: tobacco, alcohol, *HPV* infection (especially oropharyngeal cancer), *EBV* (nasopharyngeal carcinoma), poor oral hygiene.
  • Common malignancies: **Squamous cell carcinoma** (most common), lymphomas, adenocarcinomas.

Clinical Features

  • Depends on site:
    • Nasopharynx: Nasal obstruction, epistaxis, serous otitis media, neck mass.
    • Oropharynx: Sore throat, dysphagia, referred otalgia, visible mass, ulceration.
    • Hypopharynx: Late symptoms, dysphagia, hoarseness, neck mass.
  • Weight loss, fatigue in advanced disease.

Diagnosis

  • Thorough head and neck examination including endoscopy.
  • Biopsy of lesion for histopathology.
  • Imaging (*CT/MRI*) for local and regional spread; *PET-CT* for staging.

Treatment

  • Depends on stage and location:
    • Early stage: Surgery and/or radiotherapy.
    • Advanced stage: Combination of surgery, radiotherapy, and chemotherapy.
  • Regular follow-up for recurrence or metastasis.

Acute Laryngitis

Definition

  • Sudden onset inflammation of the laryngeal mucosa, usually self-limiting and lasting less than 3 weeks.

Etiology

  • Most commonly viral (e.g., rhinovirus, influenza, parainfluenza).
  • Other causes: vocal strain (excessive voice use), bacterial superinfection, exposure to irritants (smoke, chemicals).

Clinical Features

  • **Hoarseness** or loss of voice (*dysphonia/aphonia*).
  • Sore throat, dry cough, throat discomfort.
  • May follow or accompany an upper respiratory tract infection.

Diagnosis

  • Clinical diagnosis based on history and symptoms.
  • Laryngoscopy (if prolonged or severe) shows red, swollen vocal cords.
  • Rule out other causes if symptoms persist beyond 3 weeks (e.g., laryngeal tumor, reflux laryngitis).

Treatment

  • Voice rest and hydration.
  • Avoid irritants (smoking, shouting, alcohol).
  • Humidified air, analgesics, and antipyretics as needed.
  • Antibiotics only if bacterial infection is confirmed or suspected.

Chronic Laryngitis

Definition

  • Persistent inflammation of the larynx lasting more than 3 weeks, often due to ongoing irritation or repeated acute episodes.

Etiology

  • Common causes: smoking, vocal abuse/misuse, alcohol, air pollution.
  • Other contributors: **Gastroesophageal reflux disease (GERD)**, chronic sinusitis with postnasal drip, allergies.
  • Less commonly: infections (e.g., tuberculosis, syphilis), autoimmune disorders.

Clinical Features

  • Persistent hoarseness or voice fatigue.
  • Throat clearing, dry cough, sensation of throat irritation.
  • Voice changes may be progressive; rarely, breathing difficulty if severe swelling.

Diagnosis

  • Laryngoscopy: shows thickened, erythematous vocal cords, possibly with leukoplakia.
  • Rule out malignancy if risk factors present or symptoms persist.
  • Additional investigations: pH monitoring (if GERD suspected), biopsy if suspicious lesions seen.

Treatment

  • Eliminate irritants (e.g., stop smoking, reduce alcohol intake).
  • Voice therapy and vocal hygiene education.
  • Treat underlying causes (e.g., *PPIs* for GERD, nasal sprays for postnasal drip).
  • Regular monitoring if premalignant changes suspected.

Laryngeal Abscess

Definition

  • A localized collection of pus within the larynx, often involving the supraglottic or paraglottic space.

Etiology

  • Usually secondary to bacterial infection (e.g., following acute laryngitis, trauma, or foreign body).
  • Common organisms: *Streptococcus*, *Staphylococcus aureus*, anaerobes.
  • Can also result from spread of deep neck space infections or post-surgical complication.

Clinical Features

  • Severe sore throat, **odynophagia** (painful swallowing), muffled voice.
  • Fever, stridor, **dyspnea** (airway compromise if severe).
  • Neck tenderness, hoarseness, and swelling over the laryngeal area.

Diagnosis

  • Flexible laryngoscopy: swollen, bulging area in the larynx.
  • *Contrast-enhanced CT* neck: confirms abscess and extent.
  • *CBC* may show leukocytosis; cultures from aspirated pus if drained.

Treatment

  • Emergency airway management if airway compromise.
  • Surgical drainage (endoscopic or external depending on location/size).
  • *IV* antibiotics targeting aerobic and anaerobic bacteria.
  • Close monitoring and follow-up to prevent recurrence.

Acute Laryngo-Tracheo-Bronchitis (Croup)

Definition

  • A viral infection causing inflammation and edema of the larynx, trachea, and bronchi, typically in young children.

Etiology

  • Most commonly caused by **parainfluenza virus** (types 1–3).
  • Other viruses: RSV, adenovirus, influenza.
  • Affects children aged 6 months to 3 years, often in colder months.

Clinical Features

  • **Barking cough**, **inspiratory stridor**, **hoarseness**, low-grade fever.
  • Symptoms worse at night; may have respiratory distress.
  • Usually preceded by upper respiratory tract infection symptoms.

Diagnosis

  • Clinical diagnosis based on symptoms and age group.
  • Neck X-ray (AP view): “**steeple sign**” (subglottic narrowing).
  • Pulse oximetry and respiratory assessment for severity.

Treatment

  • Mild: humidified air, oral corticosteroids (e.g., dexamethasone).
  • Moderate to severe: nebulized epinephrine, oxygen if needed.
  • Hospital admission if stridor at rest, hypoxia, or poor oral intake.

Benign Tumors of the Larynx

Definition

  • Non-cancerous growths arising from the laryngeal tissues, commonly affecting the vocal cords and leading to voice changes.

Etiology

  • Vocal abuse or misuse (e.g., shouting, singing).
  • Chronic irritation (e.g., smoking, GERD, infections).
  • Congenital factors (in case of papillomas).
  • Viral cause: *HPV* (for laryngeal papillomas).

Clinical Features

  • Hoarseness, voice fatigue, throat clearing.
  • Sensation of a lump in the throat.
  • Rarely, airway obstruction if large or multiple lesions.

Common Types

  • Vocal cord nodules – “*singer’s nodules*”.
  • Polyps – unilateral, often pedunculated.
  • **Reinke’s edema** – gelatinous swelling of the vocal cords.
  • Papillomas – caused by *HPV*, may be recurrent.
  • Cysts, granulomas, and chondromas.

Diagnosis

  • Laryngoscopy: visualizes lesion characteristics (size, location, mobility).
  • Stroboscopy for vocal cord vibration assessment.
  • Histopathology (if uncertain or persistent lesion).

Treatment

  • Voice therapy and vocal hygiene (for nodules, early polyps).
  • Surgical excision (*microlaryngoscopy*) if persistent or symptomatic.
  • Laser therapy for recurrent papillomatosis.
  • Treat underlying causes (e.g., reflux, infection).

Malignant Tumors of the Larynx

Definition

  • Cancerous growths arising from the laryngeal mucosa, most commonly **squamous cell carcinoma**.

Etiology

  • Strongly associated with **smoking** and **alcohol use**.
  • Other risk factors: *HPV* (especially for supraglottic cancers), occupational exposure (e.g., asbestos), GERD.
  • More common in males >50 years.

Clinical Features

  • Depends on tumor location:
    • **Glottic**: Persistent **hoarseness** (earliest sign).
    • **Supraglottic**: Dysphagia, odynophagia, neck mass.
    • **Subglottic**: Often presents late with **airway obstruction**.
  • Advanced cases: stridor, weight loss, referred otalgia, hemoptysis.

Diagnosis

  • Indirect or fiberoptic **laryngoscopy** to visualize lesion.
  • **Biopsy** confirms diagnosis.
  • **CT/MRI** for local extent; **PET-CT** for staging and metastasis evaluation.

Treatment

  • **Early-stage**: Radiation therapy or transoral laser microsurgery.
  • **Advanced-stage**: Total or partial **laryngectomy** + radiotherapy ± chemotherapy.
  • Voice rehabilitation and regular follow-up for recurrence monitoring.

Emergency Tracheotomy

Definition

  • A life-saving surgical procedure that creates a direct airway by making an incision in the trachea through the neck.

Indications

  • Acute upper airway obstruction (e.g., severe trauma, foreign body, anaphylaxis, infection).
  • Failed intubation or inability to secure airway by other means.
  • Airway obstruction due to tumors, burns, or swelling.

Clinical Features

  • Severe respiratory distress, stridor, cyanosis.
  • Inability to ventilate or intubate.
  • Signs of hypoxia: agitation, confusion, altered consciousness.

Diagnosis

  • Mainly clinical, based on airway obstruction and failure to intubate.
  • Imaging (if time permits) to identify cause or anatomy.

Treatment

  • Immediate incision 1–2 cm below the cricoid cartilage in the midline.
  • Insert tracheostomy tube or endotracheal tube into trachea to secure airway.
  • Provide oxygenation and ventilation support.
  • Monitor for complications: bleeding, subcutaneous emphysema, pneumothorax.

Corrosive Burns of the Esophagus (Acid or Lye)

Definition

  • Chemical injury to the esophageal mucosa caused by ingestion of corrosive substances such as acids or alkalis (lye).

Etiology

  • Accidental or intentional ingestion of strong acids (e.g., hydrochloric acid) or alkalis (e.g., sodium hydroxide, lye).
  • More common in children (accidental) and adults (suicidal attempts).

Clinical Features

  • Immediate severe pain in mouth, throat, and chest.
  • Drooling, dysphagia, odynophagia.
  • Burns of lips, oral cavity, and possibly airway edema causing respiratory distress.
  • Vomiting, hematemesis, and possible perforation signs in severe cases.

Diagnosis

  • Clinical history is crucial.
  • Endoscopy within 12–24 hours to assess extent and severity (avoid if suspected perforation).
  • Imaging (X-ray, CT) to rule out perforation or mediastinitis.

Treatment

  • Do not induce vomiting or neutralize (risk of further injury).
  • Airway protection and supportive care (*IV* fluids, pain control).
  • Early endoscopic evaluation to guide management.
  • Surgery for perforation or strictures; later dilatation for strictures.
  • Avoid oral intake until safe.

Occupational Diseases of the Upper Respiratory Tract

Definition

  • Occupational diseases affecting the upper respiratory tract caused by exposure to harmful agents in the workplace.

Etiology

  • Inhalation of irritants such as dust, fumes, chemical vapors, allergens, and toxic gases.
  • Common agents: silica dust, asbestos, cotton dust, chemicals, smoke.

Clinical Features

  • Chronic rhinitis, nasal congestion, and sneezing.
  • Pharyngitis, laryngitis, and hoarseness.
  • Cough, nasal polyps, and sometimes sinonasal tumors.
  • Symptoms often improve away from the workplace (work-related pattern).

Diagnosis

  • Detailed occupational history and exposure assessment.
  • Physical exam focusing on nasal mucosa, throat, and larynx.
  • Imaging and endoscopy if indicated.
  • Allergy testing or pulmonary function tests for associated lower respiratory involvement.

Treatment

  • Avoidance or reduction of exposure to offending agents.
  • Symptomatic treatment: nasal sprays, antihistamines, corticosteroids.
  • Protective equipment (masks, respirators) at work.
  • Regular medical surveillance and early intervention to prevent progression.

Speech and Voice Disorders

Definition

  • Disorders affecting the production, quality, or clarity of speech and voice due to anatomical, neurological, or functional causes.

Etiology

  • Organic: vocal cord nodules, polyps, paralysis, laryngitis, tumors.
  • Neurological: stroke, Parkinson’s disease, cerebral palsy, vocal cord paralysis.
  • Functional: misuse, psychogenic causes, muscle tension dysphonia.

Clinical Features

  • Hoarseness, breathiness, or harsh voice.
  • Reduced vocal range or pitch control.
  • Stuttering, lisps, articulation problems.
  • Difficulty speaking or voice fatigue.
  • In severe cases, *aphonia* (loss of voice).

Diagnosis

  • Detailed history and voice assessment.
  • Laryngoscopy or videostroboscopy to visualize vocal cords.
  • Speech and language evaluation by a therapist.
  • Neurological examination if indicated.

Treatment

  • Voice therapy and speech rehabilitation.
  • Medical management for infections or inflammation.
  • Surgical intervention for lesions or paralysis.
  • Psychological support for psychogenic disorders.
  • Avoid vocal strain and proper voice hygiene.

Tuberculosis of the ENT Organs

Definition

  • Infection of the ear, nose, throat, or related structures by *Mycobacterium tuberculosis*.

Etiology

  • Primary or secondary tuberculosis involving ENT sites such as the tonsils, larynx, middle ear, or cervical lymph nodes.
  • Spread via inhalation, direct extension, or hematogenous dissemination.

Clinical Features

  • Chronic sore throat, hoarseness, or ulcerative lesions in the oropharynx or larynx.
  • Chronic ear discharge, hearing loss, and tympanic membrane perforation (in tuberculous otitis media).
  • Cervical lymphadenitis presenting as painless, slowly enlarging neck masses (**scrofula**).
  • Constitutional symptoms: weight loss, fever, night sweats.

Diagnosis

  • Clinical suspicion with history and examination.
  • *Acid-fast bacilli (AFB)* staining and culture from tissue or discharge.
  • Biopsy showing caseating granulomas.
  • Imaging (X-ray, CT) for extent of disease.
  • Tuberculin skin test or interferon-gamma release assays.

Treatment

  • Standard anti-tubercular therapy (6–9 months).
  • Surgical drainage or excision in cases of abscess or non-resolving lymph nodes.
  • Supportive care for symptom relief.
  • Regular follow-up to monitor response and complications.

Scleroma of the Upper Airway

Definition

  • Chronic granulomatous disease of the upper respiratory tract caused by ***Klebsiella rhinoscleromatis*** infection, characterized by progressive fibrosis and deformity.

Etiology

  • Endemic in certain regions (e.g., Middle East, Central America).
  • Caused by chronic bacterial infection leading to granuloma formation and scarring in the nasal cavity, nasopharynx, and larynx.

Clinical Features

  • **Catarrhal stage**: Nasal obstruction, rhinorrhea.
  • **Granulomatous stage**: Nodular masses, nasal deformity.
  • **Sclerotic stage**: Fibrosis causing stenosis, airway obstruction.
  • Progressive nasal congestion, crusting, and sometimes hoarseness or dyspnea.

Diagnosis

  • Clinical suspicion in endemic areas with characteristic lesions.
  • Biopsy showing **Mikulicz cells** (foamy macrophages) and **Russell bodies**.
  • Culture for *Klebsiella rhinoscleromatis*.
  • Imaging (CT/MRI) to assess extent and airway involvement.

Treatment

  • Long-term antibiotic therapy (e.g., rifampicin, tetracycline, or ciprofloxacin).
  • Surgical intervention to remove fibrotic tissue or relieve airway obstruction if needed.
  • Regular follow-up to monitor disease progression and complications.