2. Introductory Information
• Name: S.K
• Age : 53
• Gender : Male
• Marital Status : Married
• Family : 4 sons & 4 daughters
• Habitation : Ar-raqa – City
• Occupation: Driver
4. Complaint Details
• ER:
was severely breathless and bluish
Was given a doze of hydrocortisone
Oxygenation improved no need for
tracheotomy
5. Systems Review
• Alimentary: normal
• Genitourinary: normal
• Endocrine: normal
• Nervous: normal
• Hematological: normal
• Rheumatoid: normal
• Integumental: normal
• Cardiovascular: normal
7. ENT
• Otolgy : No deafness, No Tinnitus, No Vertigo, No
Discharge, No Pain
• Rhinology: No Obstruction, No Discharge, No Pain,
No Dysosmia, No Epistaxis
• Laryngology: No Pain, No Stridor,
Dysphagia :For Solid Materials, Not Liquids
Dysphonia (Hoarseness) : progressive for 5
months
8. • Past Medical History : None
• Past Surgical History : None
• Family History :
No History of current complaint in the family
Siblings and Children are Healthy
Parents are dead
Father died of TB 15 years ago.
9. • Social History:
The patient is a heavy smoker for a long time
that could not be determined
• He is a teetotoal
• Drug History
Over the counter drugs
10. Clinical Examination
• alert and oriented, sitting on the bed
• Well, Tall, Thin, No Skin Coloration, No Forced
Position
ENT Examination:
• Ears and Nose Examinations weren’t done.
11. Clinical Examination
• Throat Examination:
Indirect Laryngoscopy (using the laryngeal
mirror): showed a large left vocal cord mass.
• Neck Examination:
No apparent masses.
No Enlarged lymph nodes.
16. Laryngeal Cancer
Incidence
• 2 to 5 % of all cancers world wide
• The most common cancer in the head and
neck in the U.S
• Urban/Highly industrialized areas inhabitants:
Rural Inhabitants
2 or 3 : 1
The lowest reported incidence was in Syria, Singapore,
Armenia, Australia and Japan.
17. Laryngeal Cancer
Age
• 80% of cases over the fifth decade
• In Scandinavian countries tend to occur in
older ages
• Rare in Children and Adolescents
19. Laryngeal Cancer
Etiologic Factors
• Alcohol
especially in smoker who drink heavily
Supraglottic more than Glottic carcinomas
Alcoholists who smoke 25- 50 fold increase in
risk over nonsmokers
20. Laryngeal Cancer
Etiologic Factors
GERD
Environmental Pollution
Radiation of head and neck
Genetic Factors (African-American : White 2:1)
HPV infections 16 – 18
Certain Anatomic Conditions (laryngocoeles
18% of laryngeal cancers)
21. Association With Second Primary
Malignant Tumors
• Synchronously in 1%
• Metachronously in 5% to 10%
The Most common Bronchogenic
carcinoma
10% synchronously
30% during the first year
30% by five years
30% within the first 20 years
• Supraglottic : Glottic 3:1
24. Papillomatosis
• Rare after the age of 30.
• Multiple warty lesions of "true" and
"false" vocal cords.
• HPV-6 and HPV-11 are most closely
associated with papillomatosis
• small but definite risk of malignant
change (2%)
• Tracheoesophageal lesions are found in
2–15% of cases.
26. Granulomatous Disordres
Tuberculosis
• The most common
• Clinical Presentation mimic neoplastic disorders
• Third to forth decade of life
• ¼ patients presents initially with respiratory
obstruction
• The True vocal folds are the most common involved
sites
• If left untreated Cicatricial stenosis with vocal fold
fixation
