Photodynamic therapy in the treatment of fungal laryngitis

Abstract

The article describes the present-day approaches to the diagnostics and treatment of fungal infections of the larynx. The proportion of laryngomycosis in chronic inflammatory pathology is up to 24%, the main causative agents of laryngomycosis are yeast-like Candida fungi (up to 98%). The specific feature of treatment of patients with laryngomycosis is the combination of antimycotic therapy with complex laryngitis therapy. The optimal fungal laryngitis treatment method is the combined treatment with both systemic and topical antimycotics for 3 weeks using itraconazole (100–200 mg/day) or fluconazole (50–150 mg/day) and inhalations of 0.01% benzyldimethyl-myristoilamine-propylammonium solution or inhalations of amphotericin B. In case of combination of mycosis of larynx and pharynx, the treatment must be supplemented with topical pharyngomycosis therapy. The best results in the treatment of patients with fungal laryngitis are provided by combined antifungal therapy for 3 weeks in combination with endolaryngeal PhDT using 0.01% amethylene blue aqueous solution as a photosensitizer, and 0.3–0.5W laser radiation for 90–120 s under the control of indirect light guide microlaryngoscopy with diffusing tip using the apparatus Kreolka. Such combination of pharmacological and physical treatment methods has provided good results even in the patients in which the previous courses of antifungal therapy were ineffective.