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Laryngeal Ulcers

Etiology: • Mechanical pressure

Pathogenesis: • Erosion by pressure

Epidemiology: • Patients intubated for more than 24 hours

General Gross Description: • Ulcers with hemorrhagic rim and red tan base • Frequently located just below the vocal cords and anteriorly along each cartilaginous ring • Necrotic debris and neutrophils on surface • Reactive squamous epithelium with prominent nucleoli in large nuclei

General Microscopic Description: • Necrotic debris and neutrophils on surface • Reactive squamous epithelium with prominent nucleoli in large nuclei

Clinical Correlations: • Will heal completely if patient survives to extubation • Long term intubation may lead to squamous metaplasia with atypia

References: • Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders. Philadephia 1994. p. 744.