Background:
Leprosy, caused by Mycobacterium leprae, primarily affects the skin and peripheral nerves. Laryngeal involvement is uncommon and may remain unrecognized until significant airway compromise develops. The present study aims to describe the clinical spectrum, endoscopic findings, radiological characteristics, and outcomes of patients with laryngeal leprosy presenting to a tertiary care center.
Methods:
A retrospective case series was conducted involving ten patients with histopathologically confirmed lepromatous leprosy and laryngeal involvement between January 2018 and December 2025. Demographic data, clinical presentation, laryngoscopic findings, imaging characteristics, histopathology, treatment, and outcomes were analyzed.
Results:
Ten male patients with a mean age of 47.9 years (range 39–58 years) were included. Hoarseness was the most common symptom (100%), followed by dyspnea (60%) and dysphagia (40%). Cutaneous manifestations including leonine facies, madarosis, saddle nose deformity, and peripheral sensory loss were observed in all patients. Videolaryngoscopy demonstrated edema of the epiglottis, aryepiglottic folds, and false vocal cords in all cases. Vocal cord palsy was identified in six patients (60%). Computed tomography revealed varying degrees of supraglottic and glottic narrowing. Histopathological examination demonstrated granulomatous infiltration with numerous acid-fast bacilli on Fite-Faraco staining in all patients.
Conclusion:
Laryngeal leprosy remains a rare but clinically significant manifestation of lepromatous disease. Persistent hoarseness and airway symptoms in patients with leprosy warrant detailed laryngeal evaluation. Early recognition facilitates timely multidrug therapy and may prevent irreversible airway complications.