In only 10 years, the acquired immunodeficiency syndrome epidemic has already had an enormous impact on many aspects of the practice of medicine. The practice of laryngology typifies the changes that have occurred. Heightened clinical vigilance has been required as the laryngologist encounters new and unusual manifestations of the disease and must take more extensive histories regarding social, behavioral, and sexual practices than were previously necessary. The performance of physical examinations and surgical procedures has also changed as a result of experience with the lethal human immunodeficiency virus. Numerous legal, ethical, and social issues have also been raised by the epidemic and have had a major influence on how medicine is practiced and regulated. In this paper we review the laryngeal and pharyngeal manifestations of acquired immunodeficiency syndrome and discuss illustrative patient examples that demonstrate the impact of the disease. We also consider the diverse groups of issues that attend this epidemic and that continue to modify practice patterns.
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