The evolving clinical profile of laryngeal tuberculosis: a 10-year retrospective study from a tertiary hospital in northern China

Objective This study aimed to elucidate the contemporary clinical characteristics and evolving trends of laryngeal tuberculosis(LTB), thereby providing evidence for optimizing clinical diagnostic and therapeutic strategies. Methods We conducted a retrospective analysis of the clinical data from patients diagnosed with LTB at a single-center medical institution in northern China between July 2014 and June 2025. Results A total of 49 patients with LTB were included in this study, predominantly males aged 55-64 years. The most common presenting symptom was hoarseness (67.34%), while systemic symptoms were infrequent. Laryngoscopic examination revealed diverse lesion morphologies, with the mixed-pattern type being the most prevalent (38.78%). Furthermore, lesions frequently involved two or more laryngeal subsites (65.31%). Chest CT findings indicated that 73.47% of patients had concomitant active or inactive pulmonary tuberculous foci. Laboratory investigations showed a PPD-positive rate of 55.10% and a sputum smear-positive rate for acid-fast bacilli of 38.88%. Among the 32 patients who underwent pathological biopsy, classic histopathological features, including epithelial granulomas with caseous necrosis, were observed. Following anti-tuberculosis treatment, the laryngeal lesions showed significant improvement or complete resolution in the vast majority of patients. Conclusion Diagnosing LTB is often challenging due to its clinical resemblance to other laryngeal pathologies. Otorhinolaryngologists should consistently consider LTB in the differential diagnosis, particularly for patients with high-risk factors for tuberculosis who present with polymorphic lesions involving multiple laryngeal sites on laryngoscopy. Re-evaluating and thoroughly understanding the shifting trends in the clinical presentation of LTB are crucial for achieving early identification and accurate diagnosis of this disease. Clinical trial number Not applicable.