Overview
Laryngeal pachydermia refers to thickening and sclerosis of the laryngeal mucosa, often associated with chronic irritation or nutritional deficiencies, particularly essential fatty acid (EFA) deficiencies 1.Diagnosis
Clinical presentation includes hoarseness, dysphagia, and laryngeal stridor 1.
Plasma phospholipid fatty acid composition analysis can assess EFA nutriture 1.
Ratio of eicosatrienoic to arachidonic acids (20:3 omega 9/20:4 omega 6) is a key indicator of EFA status 1.Management
First-line treatments: Vitamin B-complex supplementation, showing complete clinical response in an average of 5.7 weeks 1.
Adjunctive treatments: Vitamin E supplementation (partial or total improvement in 12.3-10.7 weeks) 1.
Alternative approaches: Safflower oil showed partial improvement in 13.2 weeks 1.Special Populations
Pediatrics: EFA nutriture assessment reveals two patterns; Pattern A shows normal EFA levels, suggesting variability in response to treatment 1.Key Recommendations
Evaluate EFA status through plasma phospholipid fatty acid composition, particularly focusing on the eicosatrienoic to arachidonic acid ratio, to guide treatment 1 (Evidence: Moderate).
Initiate treatment with vitamin B-complex for laryngeal pachydermia, given its efficacy in achieving clinical improvement within 5.7 weeks 1 (Evidence: Moderate).
Consider vitamin E supplementation as an adjunctive therapy for partial or total improvement, though response times are longer compared to vitamin B-complex 1 (Evidence: Moderate).References
1 Ghafoorunissa, Vidyasagar R, Krishnaswamy K. Phrynoderma: is it an EFA deficiency disease?. European journal of clinical nutrition 1988. link