Original/ Main Article LARYNGEAL MANIEES TA TION IN PULMONARY KOCHS B. S. Tuli T. L. Parmar D. Singh S. K. Gupta T uberculosis is still regarded as the most common communicable disease in the world and there are about Yy 10 million cases of pulmonary tuberculosis in India out of which 2-2.5 million are infective. Laryngeal tuberculosis is the most common extra-pulmonary complication of pulmonary tuberculosis. Incidence of tubercular laryngitis is directly related to the incidence of pulmonary tuberculosis. Thompson (1924) cited laryngeal tuberculosis as the most common disease of the larynx. Dworetzky (1938) found that vast majority of laryngeal lesions are surface infection from tubercle bacilli. Clinically B. S. Tuli, Assistant Professor, T. L. Parmar, Professor & Head, D. Singh, Senior Lecturer, Department of ENT, Governemt Medical College, Patiala (Pb) S. K. Gupta, Professor & Head T. B. & Chest Diseases Hospital Patiala Address for Reprints Dr. (Major) B. S. Tuli 119-120 Bharpur Garden Colony Opp. Ayurvedic College Hostel Patiala (Pb) — 147 001. earlier evidence of laryngeal tuberculosis is redness of inter-arytenoid area and posterior part of vocal cord, ulcerative lesions are seen on vocal cords giving rise to `Moth Eaten Appearance' while oedematous lesions are seen on epiglottis giving it `Turban or Heart Shaped Appearance'. Local trauma, vocal cord abuse, poor host resistance and malnutrition are certain pre-disposing factors in laryngeal involvement in pulmonary tuberculosis. In sputum-negative cases, hypersensitivity of tissue is thought to be the route of spread due to introduction of antigen. But still it is a matter of speculation that why some patients with advanced phthisis escape laryngeal infection, while others succumb to it earlier. Desa (1950) in his series of 292 cases of pulmonary tuberculosis found the incidence of laryngeal involvement in 13.7% out of which vocal cords were involved in 50% cases. Singh (1971) in his study of established cases of pulmonary tuberculosis found the incidence of laryngeal involvement in 23% cases. Kackar (1971) found the incidence as low as 1:1000 in General Hospital, whi'e it was as high as 7.5% in tuberculosis sanatorium. Rohwedder (1974) in his study of 843 cases of pulmonary tuberculosis found the incidence of laryngeal involvement as 1.8%. Bailey (1981) in his study of 37 cases found that maximum number of cases involved were between 5th & 6th decade of life in contrast to 3rd & 4th decade of pre-antibiotic era. Manni(1983) in a study of 341 cases of pulmonay tuberculosis in Tanzania found the incidence of laryngeal tuberculosis as high as 26.7%. Beg & Marfani (1983) in a study of 100 cases of pulmonary tuberculosis showed larynx involvement in 37 cases. Thaller (1987) concluded that mean age of laryngeal tuberculosis was 56 years and male female ratio was 2 : 1. Aims of Study ............................. 1. To find out the incidence of laryngeal tuberculosis in established cases of pulmonary tuberculosis. 2. To find out relative incidence of laryngeal involvement in sputum- positive and sputum-negative cases. 3. To look for the site, type and degree of laryngeal involvement. Material & Methods The study was conducted on 200 cases admitted to Chest Diseases Hospital, Patiala. Out of these 200 cases, 100 cases 194 — Indian Journal of Otolaryngology and Head and Neck Surgery V olume 2, No, 4 December 1993