Congenital laryngomalacia is a condition present at birth where the structures in the larynx are weakened, causing them to collapse during breathing in infants. The main symptom is a stridor sound heard when breathing in or out. It is usually diagnosed through medical history, examination, and bronchoscopy. In most cases it resolves on its own by age 18 months without treatment, though a small percentage require medical intervention. Acute laryngitis is an inflammation of the vocal cords causing hoarseness, often due to viruses, bacteria, smoke, chemicals, or voice overuse. It is diagnosed through throat examination and can be treated with rest, fluids, humidification, and antibiotics if bacterial. Symptoms usually resolve
This document discusses chronic suppurative otitis media (CSOM), which is a long-standing middle ear infection characterized by ear discharge and a permanent perforation of the eardrum. It describes the two main types of CSOM - tubotympanic and atticoantral - and covers their etiology, pathology, clinical features, investigations, treatment, and complications. Cholesteatoma, a growth of skin cells in the middle ear, is also discussed in detail including its origin, classification, expansion and bone destruction potential, and role in increasing risk of complications from middle ear infections.
Acute otitis media (AOM) secretory otitis media (OME)Ausaf Khan
Secretory otitis media (SOM) is characterized by the collection of non-purulent fluid in the middle ear, causing hearing impairment. It is often caused by eustachian tube obstruction from conditions like adenoid hypertrophy or nasal pharyngeal carcinoma. Patients present with bilateral deafness and mouth breathing. Examination finds a dull, retracted, immobile tympanic membrane with fluid visible behind it on pneumatic otoscopy. Treatment involves adenoidectomy and sometimes grommet insertion, though complications can include atelactasis, tympanosclerosis, or adhesive otitis media if left untreated.
The document describes various types of rhinitis including infective causes like the common cold from viruses like rhinovirus and influenza. It also discusses chronic rhinitis, which can be simple or hypertrophic. Non-infective causes like allergic rhinitis are mentioned. Specific conditions involving the nasal mucosa are outlined such as atrophic rhinitis, ozaena, rhinoscleroma, and nasal cholesteatoma. Causes, symptoms, examinations, and treatments are provided for each condition in the summary.
Acute laryngitis is swelling of the laryngeal mucosa that is usually caused by viral or bacterial infections. The main symptoms are hoarseness, throat discomfort, and cough. Treatment focuses on voice rest, steam inhalations, medications to reduce symptoms, and antibiotics for bacterial infections. Acute laryngitis in children can sometimes lead to laryngotracheobronchitis (croup) or subglottic laryngitis (pseudocroup), which present more urgently with stridor, dyspnea, and cyanosis and may require hospitalization, oxygen, steroids, or intubation. Rare forms of acute laryngitis include membranous laryngitis, acute epig
This document discusses tinnitus, including its definition, epidemiology, evaluation, and various treatment options. It provides an overview of pulsatile tinnitus and its etiologies. Evaluation involves patient history, exams, and tests. Treatments discussed include lidocaine, benzodiazepines, antidepressants, stapedectomy, electrical stimulation, and enoxaparin, with evidence for their effectiveness. Other options like acupuncture, ginkgo biloba, and hyperbaric oxygen showed no effect or mixed results.
The document discusses various laryngeal disorders including acute epiglottitis, acute laryngitis, acute laryngitis in children, and chronic laryngitis.
Acute epiglottitis is a dangerous condition characterized by sudden swelling of the epiglottis which can cause airway obstruction. It requires immediate hospitalization, monitoring, antibiotics, steroids, and possibly tracheostomy.
Acute laryngitis is usually caused by a viral infection and causes hoarseness. It is typically self-limiting but requires voice rest, steam inhalation, and sometimes antibiotics/steroids.
Acute laryngitis in children can progress rapidly due to anatomical factors and cause str
This document discusses deaf mutism and provides information on its causes, evaluation, and management. It can be caused by prenatal issues like infections or drugs during pregnancy, as well as perinatal causes such as anoxia or prematurity. Postnatal causes include genetic factors, viral infections, and ototoxic drugs. Evaluation involves a detailed history, physical exam, and tests like OAEs and ABRs. Management depends on the degree and type of hearing loss and may include hearing aids, cochlear implants, speech and language development, and vocational guidance. Cochlear implants can provide useful hearing for those with severe to profound hearing loss who don't benefit from hearing aids. Outcomes are generally better for younger patients
This document discusses chronic otitis media, including tubotympanic and atticoantral types. Tubotympanic type is a safe inflammation of the middle ear lining, while atticoantral type involves a cholesteatoma sac. Symptoms include ear discharge and deafness. Examination may reveal perforations or debris in the ear canal. Investigations include culture, endoscopy and imaging. Management involves medical treatment like cleaning or antibiotics, with surgery for more severe cases like mastoidectomy or tympanoplasty.
This document discusses chronic suppurative otitis media (CSOM), which is a long-standing middle ear infection characterized by ear discharge and a permanent perforation of the eardrum. It describes the two main types of CSOM - tubotympanic and atticoantral - and covers their etiology, pathology, clinical features, investigations, treatment, and complications. Cholesteatoma, a growth of skin cells in the middle ear, is also discussed in detail including its origin, classification, expansion and bone destruction potential, and role in increasing risk of complications from middle ear infections.
Acute otitis media (AOM) secretory otitis media (OME)Ausaf Khan
Secretory otitis media (SOM) is characterized by the collection of non-purulent fluid in the middle ear, causing hearing impairment. It is often caused by eustachian tube obstruction from conditions like adenoid hypertrophy or nasal pharyngeal carcinoma. Patients present with bilateral deafness and mouth breathing. Examination finds a dull, retracted, immobile tympanic membrane with fluid visible behind it on pneumatic otoscopy. Treatment involves adenoidectomy and sometimes grommet insertion, though complications can include atelactasis, tympanosclerosis, or adhesive otitis media if left untreated.
The document describes various types of rhinitis including infective causes like the common cold from viruses like rhinovirus and influenza. It also discusses chronic rhinitis, which can be simple or hypertrophic. Non-infective causes like allergic rhinitis are mentioned. Specific conditions involving the nasal mucosa are outlined such as atrophic rhinitis, ozaena, rhinoscleroma, and nasal cholesteatoma. Causes, symptoms, examinations, and treatments are provided for each condition in the summary.
Acute laryngitis is swelling of the laryngeal mucosa that is usually caused by viral or bacterial infections. The main symptoms are hoarseness, throat discomfort, and cough. Treatment focuses on voice rest, steam inhalations, medications to reduce symptoms, and antibiotics for bacterial infections. Acute laryngitis in children can sometimes lead to laryngotracheobronchitis (croup) or subglottic laryngitis (pseudocroup), which present more urgently with stridor, dyspnea, and cyanosis and may require hospitalization, oxygen, steroids, or intubation. Rare forms of acute laryngitis include membranous laryngitis, acute epig
This document discusses tinnitus, including its definition, epidemiology, evaluation, and various treatment options. It provides an overview of pulsatile tinnitus and its etiologies. Evaluation involves patient history, exams, and tests. Treatments discussed include lidocaine, benzodiazepines, antidepressants, stapedectomy, electrical stimulation, and enoxaparin, with evidence for their effectiveness. Other options like acupuncture, ginkgo biloba, and hyperbaric oxygen showed no effect or mixed results.
The document discusses various laryngeal disorders including acute epiglottitis, acute laryngitis, acute laryngitis in children, and chronic laryngitis.
Acute epiglottitis is a dangerous condition characterized by sudden swelling of the epiglottis which can cause airway obstruction. It requires immediate hospitalization, monitoring, antibiotics, steroids, and possibly tracheostomy.
Acute laryngitis is usually caused by a viral infection and causes hoarseness. It is typically self-limiting but requires voice rest, steam inhalation, and sometimes antibiotics/steroids.
Acute laryngitis in children can progress rapidly due to anatomical factors and cause str
This document discusses deaf mutism and provides information on its causes, evaluation, and management. It can be caused by prenatal issues like infections or drugs during pregnancy, as well as perinatal causes such as anoxia or prematurity. Postnatal causes include genetic factors, viral infections, and ototoxic drugs. Evaluation involves a detailed history, physical exam, and tests like OAEs and ABRs. Management depends on the degree and type of hearing loss and may include hearing aids, cochlear implants, speech and language development, and vocational guidance. Cochlear implants can provide useful hearing for those with severe to profound hearing loss who don't benefit from hearing aids. Outcomes are generally better for younger patients
This document discusses chronic otitis media, including tubotympanic and atticoantral types. Tubotympanic type is a safe inflammation of the middle ear lining, while atticoantral type involves a cholesteatoma sac. Symptoms include ear discharge and deafness. Examination may reveal perforations or debris in the ear canal. Investigations include culture, endoscopy and imaging. Management involves medical treatment like cleaning or antibiotics, with surgery for more severe cases like mastoidectomy or tympanoplasty.
Pharyngitis, or sore throat, is usually caused by viral or bacterial infections. The most common infectious agents are streptococcus pyogenes bacteria and various viruses like rhinovirus. Symptoms include fever, throat pain, and difficulty swallowing. Treatment depends on the cause, but viral infections generally resolve with supportive care while bacterial streptococcal infections are treated with antibiotics to prevent complications like rheumatic fever. Accurate diagnosis is important to guide treatment and prevent spread to others.
This document discusses the intracranial complications that can arise from otitis media, including meningitis, brain abscesses, lateral sinus thrombophlebitis, epidural abscesses, subdural abscesses, and otitic hydrocephalus. For each complication, the document outlines the pathology, clinical features, diagnostic process, and treatment options. The most common and serious complication is meningitis, which can develop from both acute and chronic otitis media. Brain abscesses occur in stages and present with symptoms of increased intracranial pressure. Lateral sinus thrombophlebitis involves inflammation and clotting within the venous sinus.
Viral laryngitis is the most common cause of laryngeal infection and presents with symptoms like dysphonia, odynophagia, and laryngeal trauma from phonation and coughing. Bacterial laryngitis can also occur from pathogens like Streptococcus and Staphylococcus and may result in supraglottitis or epiglottitis. Fungal, mycobacterial, and other infections like leprosy and syphilis can also infect the larynx, especially in immunocompromised patients. Autoimmune conditions such as Wegener's granulomatosis, rheumatoid arthritis, relapsing polychondritis, and pemphigus/pemphigoid can cause
The document discusses diseases of the external ear, including:
1. Congenital disorders like atresia of the ear canal and microtia.
2. Acquired disorders of the pinna like hematoma, perichondritis, and keloid formation.
3. Infections of the external ear including perichondritis, herpes zoster oticus, and different types of otitis externa like diffuse and fungal (otomycosis).
4. Surgical treatments for some conditions are discussed, like reconstruction for atresia and excision of keloids or perichondrial infections.
Acute Pharyngitis is an inflammation of the pharyngeal mucosa and submucosa, mostly involving the pharyngeal lymphoid tissue. It is commonly caused by viruses or bacteria. Symptoms include fever, sore throat, pain when swallowing, and enlarged lymph nodes in the neck. Examination shows redness and swelling of the throat. Chronic Pharyngitis is a diffuse inflammation of the pharyngeal mucosa that can develop from repeated acute infections. It may cause hypertrophy or atrophy of the mucosa. Treatment focuses on identifying and eliminating the cause, using local soothing treatments, and targeting hypertrophied tissues if needed. Therapy is often unsatisfactory due to high rates
Diana Harbuz provides a summary of common ENT issues including:
1. Mastoiditis, otitis externa, perichondritis, and haematoma in the ears section.
2. Epistaxis and sinusitis/meningitis/CSF rhinorrhoea in the nose section.
3. Peritonsillar abscess, epiglottitis, retropharyngeal abscesses, Ludwigs angina, laryngomalacia, and angiooedema in the throat section.
4. Emergency management of laryngectomy/tracheostomy patients, parotitis, and facial cellulitis referral guidelines in the head and neck
This document summarizes various causes and types of sensori-neural hearing loss (SNHL). It notes that SNHL affects 278 million people worldwide according to the WHO, and is one of the top 20 global burdens of disease. Causes include genetic syndromic and non-syndromic conditions present at birth, as well as acquired causes like presbyacusis, noise-induced hearing loss, ototoxicity from certain drugs, trauma, and idiopathic sudden SNHL. Ototoxic drugs like aminoglycoside antibiotics and chemotherapy agents can cause permanent SNHL. Prevention, early detection, and treatment options vary depending on the underlying cause.
This document discusses acute suppurative otitis media (ASOM), including its definition, stages, bacteriology, treatment, and potential complications. ASOM is a pyogenic infection of the middle ear cleft lasting less than 3 weeks that is caused most commonly by streptococcus pneumoniae, haemophilus influenzae, or moraxella catarrhalis. It progresses through stages of hyperemia, exudation, suppuration, and sometimes coalescent mastoiditis. Treatment involves antibiotics, analgesics, and sometimes myringotomy to drain the ear. Complications can include subperiosteal abscess, vertigo, or mastoiditis if not properly treated.
This document provides information on various ear, nose, throat and head and neck conditions commonly seen in emergency departments. It discusses the presentation, investigations, management and criteria for admission of nasal fractures, epistaxis, post-tonsillectomy bleeding, ear emergencies, head and neck infections, and ingested foreign bodies. Procedures for examining and removing foreign bodies from the throat are also outlined. The document serves as a guide for evaluating and treating ENT emergencies.
This document discusses various inflammatory diseases of the pharynx, including adenoid hypertrophy, acute non-specific pharyngitis, diphtheritic pharyngitis, and Vincent's angina. Adenoid hypertrophy involves chronic inflammation and enlargement of the adenoids, commonly seen in children, which can cause nasal obstruction, ear infections, and maldevelopment of the face. Acute non-specific pharyngitis is usually viral in origin and causes mild sore throat, while diphtheritic pharyngitis is a severe, contagious infection caused by Corynebacterium diphtheriae that can be life-threatening. Vincent's angina involves acute ulcers
Atrophic rhinitis is a chronic inflammatory disease characterized by atrophy of the nasal mucosa and turbinates. It is classified as primary or secondary. Primary atrophic rhinitis has no identifiable cause, while secondary is caused by infections, surgery, or nasal septal deviations. Symptoms include a fetid odor, crusting, and nasal obstruction. Treatment involves local and systemic antibiotics, steroids, irrigation, and surgical procedures like Young's operation to reduce nasal volume and crusts.
This document discusses sudden sensorineural hearing loss (SSNHL). It notes that SSNHL is devastating for patients and frustrating for doctors, with the cause often unknown. Key points include that the annual incidence is 5-20 cases per 100,000 people, 90% of cases are idiopathic, and potential causes include infection, trauma, vascular issues, tumors, and autoimmune disorders. Treatment options discussed include steroids, intratympanic steroids, hyperbaric oxygen therapy, carbogen, antivirals, and diuretics. The prognosis is generally good, with 65% recovering hearing within 2 weeks.
1. The document discusses various diseases that affect the external nose and nasal vestibule including nasal deformities, meningoencephalocele, glioma, benign and malignant tumors, furuncle, and vestibulitis.
2. Common nasal deformities include saddle nose, hump nose, crooked nose, and deviated nose which can be corrected through rhinoplasty or septorhinoplasty.
3. Meningoencephalocele is a herniation of brain tissue through a congenital bony defect, while glioma is a residual portion of encephalocele.
4. Benign tumors include rhinophyma and papilloma, while basal cell
The document summarizes acute epiglottitis, an inflammatory condition of the supraglottic structures including the epiglottis, aryepiglottic folds, and arytenoids that can cause airway obstruction. It describes the anatomy of the epiglottis, causes including H. influenzae infection, symptoms of sore throat and difficulty swallowing, signs of fever and swelling of the epiglottis, diagnosis through examination and imaging, complications of spread of infection, treatment with antibiotics, steroids, and intubation if needed, and good prognosis with timely treatment but risk of sudden airway obstruction.
This document summarizes various laryngeal inflammations including acute and chronic laryngitis. It describes the etiology, clinical features, investigations, and treatment for conditions like acute laryngitis, acute epiglottitis, acute laryngotracheobronchitis (croup), chronic laryngitis, Reinke's edema, and tuberculosis of the larynx. Key signs and findings are emphasized for differentiating these conditions. Management involves supportive care, medications, steroids, antibiotics, intubation or tracheostomy as needed based on the specific condition.
This document discusses various conditions affecting the external ear, including congenital deformities, traumatic injuries, and inflammatory conditions. It covers topics like perichondritis, fungal infections like otomycosis, furuncles, eczema, and cerumen impaction. For each condition, it describes etiology, symptoms, examination findings, and treatment approaches.
Tinnitus is a ringing, swishing, or other noise that seems to originate in the ear or head, and is not a disease itself. It can be caused by ageing, noise exposure, ear infections, medications, and other conditions. Treatment depends on the underlying cause but often involves sound therapy, medications, or cognitive behavioral therapy since there is no cure. Laser therapy applied to the external ear and mastoid bone area is also used as a treatment approach.
Rhinisinusitis bullet point,type,causative organism,investigation,treatment
quick overview ,easy understanding
ref:Scott-Brown's Otorhinolaryngology and Head and Neck Surgery
This document discusses laryngomalacia (LM), which is the most common cause of stridor in infants. LM is a congenital laryngeal anomaly characterized by inward collapse of the supraglottic structures during inspiration, leading to airway obstruction. It is often associated with prematurity, male sex, neurological impairment, and gastroesophageal reflux disease. Flexible laryngoscopy is used to classify LM severity and diagnose it, while microlaryngoscopy provides the best view of laryngeal structures. Treatment involves observation, medical management of reflux, or supraglottoplasty surgery for severe cases causing respiratory distress. Supraglottoplasty removes redundant supraglottic tissue to widen
La laringomalacia es la malformación congénita más frecuente de la vía aérea superior, causada por la flacidez de los tejidos laríngeos que provoca el colapso durante la inspiración. Se caracteriza por el estridor inspiratorio que suele aparecer en los primeros meses de vida. Afecta más a niños que a niñas y generalmente se resuelve espontáneamente a los 2 años. Requiere tratamiento quirúrgico solo en el 10% de los casos graves que presentan apneas u otros riesgos para la vida.
Pharyngitis, or sore throat, is usually caused by viral or bacterial infections. The most common infectious agents are streptococcus pyogenes bacteria and various viruses like rhinovirus. Symptoms include fever, throat pain, and difficulty swallowing. Treatment depends on the cause, but viral infections generally resolve with supportive care while bacterial streptococcal infections are treated with antibiotics to prevent complications like rheumatic fever. Accurate diagnosis is important to guide treatment and prevent spread to others.
This document discusses the intracranial complications that can arise from otitis media, including meningitis, brain abscesses, lateral sinus thrombophlebitis, epidural abscesses, subdural abscesses, and otitic hydrocephalus. For each complication, the document outlines the pathology, clinical features, diagnostic process, and treatment options. The most common and serious complication is meningitis, which can develop from both acute and chronic otitis media. Brain abscesses occur in stages and present with symptoms of increased intracranial pressure. Lateral sinus thrombophlebitis involves inflammation and clotting within the venous sinus.
Viral laryngitis is the most common cause of laryngeal infection and presents with symptoms like dysphonia, odynophagia, and laryngeal trauma from phonation and coughing. Bacterial laryngitis can also occur from pathogens like Streptococcus and Staphylococcus and may result in supraglottitis or epiglottitis. Fungal, mycobacterial, and other infections like leprosy and syphilis can also infect the larynx, especially in immunocompromised patients. Autoimmune conditions such as Wegener's granulomatosis, rheumatoid arthritis, relapsing polychondritis, and pemphigus/pemphigoid can cause
The document discusses diseases of the external ear, including:
1. Congenital disorders like atresia of the ear canal and microtia.
2. Acquired disorders of the pinna like hematoma, perichondritis, and keloid formation.
3. Infections of the external ear including perichondritis, herpes zoster oticus, and different types of otitis externa like diffuse and fungal (otomycosis).
4. Surgical treatments for some conditions are discussed, like reconstruction for atresia and excision of keloids or perichondrial infections.
Acute Pharyngitis is an inflammation of the pharyngeal mucosa and submucosa, mostly involving the pharyngeal lymphoid tissue. It is commonly caused by viruses or bacteria. Symptoms include fever, sore throat, pain when swallowing, and enlarged lymph nodes in the neck. Examination shows redness and swelling of the throat. Chronic Pharyngitis is a diffuse inflammation of the pharyngeal mucosa that can develop from repeated acute infections. It may cause hypertrophy or atrophy of the mucosa. Treatment focuses on identifying and eliminating the cause, using local soothing treatments, and targeting hypertrophied tissues if needed. Therapy is often unsatisfactory due to high rates
Diana Harbuz provides a summary of common ENT issues including:
1. Mastoiditis, otitis externa, perichondritis, and haematoma in the ears section.
2. Epistaxis and sinusitis/meningitis/CSF rhinorrhoea in the nose section.
3. Peritonsillar abscess, epiglottitis, retropharyngeal abscesses, Ludwigs angina, laryngomalacia, and angiooedema in the throat section.
4. Emergency management of laryngectomy/tracheostomy patients, parotitis, and facial cellulitis referral guidelines in the head and neck
This document summarizes various causes and types of sensori-neural hearing loss (SNHL). It notes that SNHL affects 278 million people worldwide according to the WHO, and is one of the top 20 global burdens of disease. Causes include genetic syndromic and non-syndromic conditions present at birth, as well as acquired causes like presbyacusis, noise-induced hearing loss, ototoxicity from certain drugs, trauma, and idiopathic sudden SNHL. Ototoxic drugs like aminoglycoside antibiotics and chemotherapy agents can cause permanent SNHL. Prevention, early detection, and treatment options vary depending on the underlying cause.
This document discusses acute suppurative otitis media (ASOM), including its definition, stages, bacteriology, treatment, and potential complications. ASOM is a pyogenic infection of the middle ear cleft lasting less than 3 weeks that is caused most commonly by streptococcus pneumoniae, haemophilus influenzae, or moraxella catarrhalis. It progresses through stages of hyperemia, exudation, suppuration, and sometimes coalescent mastoiditis. Treatment involves antibiotics, analgesics, and sometimes myringotomy to drain the ear. Complications can include subperiosteal abscess, vertigo, or mastoiditis if not properly treated.
This document provides information on various ear, nose, throat and head and neck conditions commonly seen in emergency departments. It discusses the presentation, investigations, management and criteria for admission of nasal fractures, epistaxis, post-tonsillectomy bleeding, ear emergencies, head and neck infections, and ingested foreign bodies. Procedures for examining and removing foreign bodies from the throat are also outlined. The document serves as a guide for evaluating and treating ENT emergencies.
This document discusses various inflammatory diseases of the pharynx, including adenoid hypertrophy, acute non-specific pharyngitis, diphtheritic pharyngitis, and Vincent's angina. Adenoid hypertrophy involves chronic inflammation and enlargement of the adenoids, commonly seen in children, which can cause nasal obstruction, ear infections, and maldevelopment of the face. Acute non-specific pharyngitis is usually viral in origin and causes mild sore throat, while diphtheritic pharyngitis is a severe, contagious infection caused by Corynebacterium diphtheriae that can be life-threatening. Vincent's angina involves acute ulcers
Atrophic rhinitis is a chronic inflammatory disease characterized by atrophy of the nasal mucosa and turbinates. It is classified as primary or secondary. Primary atrophic rhinitis has no identifiable cause, while secondary is caused by infections, surgery, or nasal septal deviations. Symptoms include a fetid odor, crusting, and nasal obstruction. Treatment involves local and systemic antibiotics, steroids, irrigation, and surgical procedures like Young's operation to reduce nasal volume and crusts.
This document discusses sudden sensorineural hearing loss (SSNHL). It notes that SSNHL is devastating for patients and frustrating for doctors, with the cause often unknown. Key points include that the annual incidence is 5-20 cases per 100,000 people, 90% of cases are idiopathic, and potential causes include infection, trauma, vascular issues, tumors, and autoimmune disorders. Treatment options discussed include steroids, intratympanic steroids, hyperbaric oxygen therapy, carbogen, antivirals, and diuretics. The prognosis is generally good, with 65% recovering hearing within 2 weeks.
1. The document discusses various diseases that affect the external nose and nasal vestibule including nasal deformities, meningoencephalocele, glioma, benign and malignant tumors, furuncle, and vestibulitis.
2. Common nasal deformities include saddle nose, hump nose, crooked nose, and deviated nose which can be corrected through rhinoplasty or septorhinoplasty.
3. Meningoencephalocele is a herniation of brain tissue through a congenital bony defect, while glioma is a residual portion of encephalocele.
4. Benign tumors include rhinophyma and papilloma, while basal cell
The document summarizes acute epiglottitis, an inflammatory condition of the supraglottic structures including the epiglottis, aryepiglottic folds, and arytenoids that can cause airway obstruction. It describes the anatomy of the epiglottis, causes including H. influenzae infection, symptoms of sore throat and difficulty swallowing, signs of fever and swelling of the epiglottis, diagnosis through examination and imaging, complications of spread of infection, treatment with antibiotics, steroids, and intubation if needed, and good prognosis with timely treatment but risk of sudden airway obstruction.
This document summarizes various laryngeal inflammations including acute and chronic laryngitis. It describes the etiology, clinical features, investigations, and treatment for conditions like acute laryngitis, acute epiglottitis, acute laryngotracheobronchitis (croup), chronic laryngitis, Reinke's edema, and tuberculosis of the larynx. Key signs and findings are emphasized for differentiating these conditions. Management involves supportive care, medications, steroids, antibiotics, intubation or tracheostomy as needed based on the specific condition.
This document discusses various conditions affecting the external ear, including congenital deformities, traumatic injuries, and inflammatory conditions. It covers topics like perichondritis, fungal infections like otomycosis, furuncles, eczema, and cerumen impaction. For each condition, it describes etiology, symptoms, examination findings, and treatment approaches.
Tinnitus is a ringing, swishing, or other noise that seems to originate in the ear or head, and is not a disease itself. It can be caused by ageing, noise exposure, ear infections, medications, and other conditions. Treatment depends on the underlying cause but often involves sound therapy, medications, or cognitive behavioral therapy since there is no cure. Laser therapy applied to the external ear and mastoid bone area is also used as a treatment approach.
Rhinisinusitis bullet point,type,causative organism,investigation,treatment
quick overview ,easy understanding
ref:Scott-Brown's Otorhinolaryngology and Head and Neck Surgery
This document discusses laryngomalacia (LM), which is the most common cause of stridor in infants. LM is a congenital laryngeal anomaly characterized by inward collapse of the supraglottic structures during inspiration, leading to airway obstruction. It is often associated with prematurity, male sex, neurological impairment, and gastroesophageal reflux disease. Flexible laryngoscopy is used to classify LM severity and diagnose it, while microlaryngoscopy provides the best view of laryngeal structures. Treatment involves observation, medical management of reflux, or supraglottoplasty surgery for severe cases causing respiratory distress. Supraglottoplasty removes redundant supraglottic tissue to widen
La laringomalacia es la malformación congénita más frecuente de la vía aérea superior, causada por la flacidez de los tejidos laríngeos que provoca el colapso durante la inspiración. Se caracteriza por el estridor inspiratorio que suele aparecer en los primeros meses de vida. Afecta más a niños que a niñas y generalmente se resuelve espontáneamente a los 2 años. Requiere tratamiento quirúrgico solo en el 10% de los casos graves que presentan apneas u otros riesgos para la vida.
Laryngomalacia is the most common congenital larynx anomaly characterized by partial or complete collapse of the supraglottic structures on inspiration, causing noisy breathing in infants. It is usually mild and transient, resolving by age 1-2 years, but may require surgical intervention if respiratory complications develop. Treatment involves managing gastroesophageal reflux if present and in rare cases supraglottoplasty to widen the airway if respiratory distress persists.
This document discusses several congenital laryngeal disorders classified by location in the larynx. Laryngomalacia, the most common cause of congenital stridor, involves soft, flabby laryngeal tissues that prolapse inward during inspiration. Laryngoceles are air-filled dilations of the laryngeal saccule that can be internal, external, or combined. They may cause respiratory distress or neck swelling. Laryngeal webs are failures of complete laryngeal canalization, most commonly involving the vocal cords. They can cause weak crying, recurrent croup, or inspiratory stridor. Flexible laryngoscopy is used to diagnose these conditions, while management depends on severity and may include observation,
Asma y-situaconesextret de docencia rafalafena Beatriz Bustosalex lazaro algado
El documento habla sobre el asma en situaciones especiales. Describe el asma y el embarazo, el asma de control difícil, el asma relacionada con el trabajo, la disfunción de las cuerdas vocales y el asma y deporte. Explica los efectos del asma en el embarazo y las recomendaciones para su tratamiento, así como las características y tratamiento del asma de control difícil y ocupacional.
1) La espirometría y otras pruebas funcionales respiratorias como la capacidad de difusión pulmonar y los volúmenes pulmonares se utilizan para evaluar enfermedades pulmonares como EPOC, asma y enfermedades restrictivas.
2) Estas pruebas miden parámetros como el volumen espiratorio forzado en 1 segundo y la relación FEV1/FVC para diagnosticar y clasificar la gravedad de la obstrucción al flujo aéreo.
3) La capacidad de difusión y otros estudios complementarios
Este documento describe varias patologías congénitas de la laringe y la tráquea. La laringomalacia es la anomalía laríngea congénita más frecuente, causando colapso de los tejidos supraglóticos durante la inspiración. Otras patologías descritas incluyen parálisis de cuerdas vocales, estenosis subglótica congénita, atresias y membranas laríngeas. El diagnóstico y tratamiento varían según el tipo y gravedad de la patología.
This document provides information about pneumonia, including epidemiology, common causes, diagnosis, treatment, and prevention. It notes that pneumonia affects over 3 million people annually in the US, with higher rates in winter and among males and those over 65. Diagnosis involves clinical assessment of symptoms and signs, with chest x-ray and testing to confirm. Treatment depends on location of acquisition and risk factors, starting with broad-spectrum antibiotics and later targeting likely pathogens. Prevention focuses on vaccination, especially for influenza and pneumococcus, and reducing risk factors like smoking.
Pneumonia is an inflammatory lung condition caused by bacteria or viruses that enter the lungs. When pathogens enter the alveoli, or air sacs, white blood cells rush to fight the infection, filling the sacs with fluid and pus. Streptococcus pneumoniae is the most common bacterial cause. Risk factors include old age, smoking, lung diseases, and weakened immunity. Symptoms include fever, chills, cough with colored mucus, chest pain, and difficulty breathing. Diagnosis involves physical exam, chest x-rays, and tests of sputum or blood. Antibiotics treat bacterial pneumonia while rest and fluids help viral cases. Vaccines can prevent pneumococcal pneumonia.
Pneumonia is an inflammation of the lungs caused by infections that fill the air sacs with fluid or pus. There are two main types: primary pneumonia develops from direct inhalation of pathogens, while secondary pneumonia occurs due to another illness. Pneumonia has many causes including bacteria, viruses, and chemicals. It can range from mild to life-threatening, especially in young, old, or immune compromised patients. Treatment depends on the cause but often involves antibiotics, oxygen, fluids and rest. Vaccines can prevent some bacterial types of pneumonia.
This document provides an overview of laryngeal anatomy including:
- The development of the larynx from embryology to differences between pediatric and adult larynx.
- Descriptions of the cartilages, muscles, membranes and nerves of the larynx.
- Details on the sizes and dimensions of structures in the larynx between males and females.
- Identification and descriptions of the supraglottic, glottic, and subglottic regions as well as the spaces within the larynx.
- Explanations of the extrinsic and intrinsic muscles of the larynx and their actions.
This document discusses tracheal anatomy and disorders. It provides details on the structure and dimensions of the trachea, as well as its relations to surrounding structures. Various congenital abnormalities, injuries, and diseases that can cause tracheal narrowing or stenosis are described. Post-intubation stenosis is highlighted as a common cause of acquired tracheal narrowing, often appearing as eccentric or concentric soft tissue narrowing on imaging while the cartilage remains intact.
The document describes the respiratory system and its functions. It discusses how respiration includes pulmonary ventilation where air moves in and out of the lungs, gas exchange between the blood and air in the alveoli, and transport of gases between the lungs and body cells. It also describes cellular respiration where oxygen is used by cells and carbon dioxide is produced. The respiratory organs include the conducting zone which carries air to the respiratory zone in the lungs where gas exchange occurs.
This document discusses several congenital laryngeal abnormalities: laryngomalacia, vocal cord paralysis, subglottic stenosis, laryngeal web, subglottic hemangioma, laryngoesophageal cleft, laryngocele, and laryngeal cyst. It provides details on the characteristics, diagnosis, and treatment of each condition. Laryngomalacia is the most common, appearing at birth as excessive flaccidity and stridor that usually resolves by age 2. Flexible laryngoscopy is useful for diagnosing many of these conditions, while treatment depends on the severity but may include observation, steroids, or laser excision.
Pneumonia is an infection that inflames the lungs and causes symptoms like cough, fever, and difficulty breathing. It can be caused by bacteria, viruses, or fungi. Diagnosis involves chest x-rays, sputum tests, and blood tests. Treatment depends on the cause but may include antibiotics, oxygen therapy, or fluids. Complications can include lung abscesses or fluid in the chest. Vaccines can help prevent pneumonia.
The document discusses various congenital lesions of the larynx that can cause stridor in infants and children, including laryngomalacia, vocal fold paralysis, subglottic stenosis, laryngeal web, and subglottic hemangioma. It describes the clinical presentation, diagnosis, and treatment of each condition. The document also covers acquired causes of stridor and outlines the approach to evaluating and managing a child presenting with stridor.
Wheeze is a high-pitched whistling sound caused by airflow moving through partially obstructed airways. It is produced when air passes through narrowed portions of the airways at high velocity, causing the airway walls to vibrate and alternately flatten and reopen. This vibration creates a continuous musical sound. Wheeze can be caused by conditions that narrow the airways such as asthma, bronchitis, pneumonia, and foreign body obstruction.
Tuberculosis Treatment Symposia - The CRUDEM Foundation presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
A 6-year-old male child was admitted to the pediatric ward with hematuria and burning urination. Tests revealed protein in his urine and thickened bladder walls on ultrasound. This is consistent with chronic cystitis. The document goes on to define nephrotic syndrome, discuss its pathophysiology, incidence, etiology including genetic and secondary causes, clinical features, lab investigations, management including diet and steroids, complications, and nursing considerations like monitoring intake/output and administering medications.
Carcinoma larynx recent trends in managementZia Qazi
This document discusses treatment options for carcinoma of the larynx. It provides details on the incidence, mortality rates, and survival rates for laryngeal carcinoma in various countries. It then focuses on retrospective analysis of 85 cases in Pakistan, finding high rates of advanced stage at presentation, smoking history, and transglottic tumors. Various management strategies are discussed, including partial resections, total laryngectomy, and chemoradiation. Surgical function preservation techniques like vertical partial laryngectomy, supraglottic partial laryngectomy, and supracricoid partial laryngectomy are described in detail.
Kunal Singh .Topic-4.Diseases of the larynx.ENT.GM20-148.pptxshiv847105
The document discusses various diseases of the larynx including acute laryngitis, acute laryngotracheitis, laryngeal edema, and laryngeal stenosis. It provides details on the symptoms, causes, and characteristics of each condition. Acute laryngitis causes hoarseness and cough while acute laryngotracheitis can result in difficulty breathing. Laryngeal edema is swelling of the larynx due to fluid accumulation that can obstruct the airway, and laryngeal stenosis is a narrowing of the larynx or vocal cords that leads to breathing and voice issues.
Respiratory Tract Infections- A Pharmacotherapeutic ApproachDr. Ankit Gaur
In this presentation I have tried to explain the types, etiology, pathophysiology of respiratory tract infections such as bronchitis, pnemonia, otitis media, sinusitis, pharyngitis, and their treatment
Neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteremia occurring in the first month of life. It can be caused by bacteria acquired during birth or in the NICU. Clinical signs are non-specific but may include temperature irregularity, changes in behavior or feeding, and cardiorespiratory issues. Risk factors include prematurity, rupture of membranes, maternal infection, and invasive procedures. Diagnosis involves blood and other cultures, as well as adjunctive lab tests like complete blood count and acute-phase reactants. Prompt treatment is important due to the potential for rapid progression and high mortality.
This document provides information on common childhood exanthemas (widespread rashes accompanied by systemic symptoms like fever). It discusses several specific exanthemas including measles, chickenpox, and scarlet fever. Measles is caused by a virus and presents with Koplik's spots, a maculopapular rash, and symptoms like cough and runny nose. Complications can include encephalitis. Chickenpox, caused by the varicella virus, presents with an itchy vesicular rash that crops in stages. Scarlet fever results from a toxin produced by Streptococcus bacteria and causes a distinctive pink rash. Prevention is through vaccination against measles and varicella. Treatment is
Upper respiratory infections in children 2015 Khaled Saad
Streptococcus infection causing inflammation of the throat and tonsils. Treatment involves supportive care with analgesics and anesthetics for viral infections. For bacterial Streptococcus infections, antibiotics are prescribed to prevent complications like rheumatic fever, with amoxicillin being a first line treatment. Sinusitis is usually caused by bacteria following a viral upper respiratory infection. Symptoms include nasal discharge and facial pain. Antibiotics like amoxicillin-clavulanate are prescribed. Acute otitis media is an ear infection that can be preceded by upper respiratory infections. It is usually treated with antibiotics like amoxicillin.
Pneumonia is a serious lung infection that remains a major cause of death worldwide, especially among young children and the elderly. It poses a significant public health issue as it is more prevalent in developing countries and among vulnerable populations with limited access to healthcare. Effective prevention of pneumonia requires vaccination programs, education, treatment of underlying risk factors, and access to medical care for early diagnosis and management of the infection.
Whooping cough is caused by the bacterium Bordetella pertussis. It begins with mild coughing and progresses to violent coughing fits ending in a "whoop" sound and often vomiting. It can affect people of all ages but is most dangerous for babies under 1 year old. Treatment involves antibiotics to limit symptoms and speed recovery, while vaccination helps prevent whooping cough. Complementary therapies may also help reduce symptoms during treatment.
Dr.vijaysundaram,acute & chronic infections larynx ,12.09.16ophthalmgmcri
The document discusses acute and chronic infections of the larynx. Viral infections are the most common cause of acute larynx, while reflux is the most common cause of chronic laryngitis. Candidal laryngitis can occur in non-immunocompromised patients. Chronic laryngitis can be caused by bacterial, fungal, mycobacterial, or non-infectious factors like smoking or reflux. Systemic diseases can also manifest with laryngeal symptoms like hoarseness or airway issues, mimicking laryngeal carcinoma.
Pertussis, also known as whooping cough, is a highly contagious bacterial disease caused by Bordetella pertussis. It is characterized by severe coughing fits that sometimes end in a "whooping" sound. The disease spreads through direct contact or droplets from coughing or sneezing. Symptoms include a catarrhal stage with mild cough followed by a paroxysmal stage with severe coughing fits that can cause vomiting, and finally a convalescent stage where coughing lessens over weeks. Treatment focuses on limiting coughing fits and preventing spread through vaccination.
Croup is a viral condition that causes swelling around the vocal cords and results in a barking cough, difficulty breathing, and hoarse voice. It is most common in children under 5 years old and is caused by viruses like parainfluenza that also cause the common cold. Mild cases are treated with cough medicine, humidifiers, and pain relievers at home. Severe cases requiring breathing treatments or steroids are treated in the emergency room. Prevention focuses on hand washing and vaccinations to avoid the viruses that cause croup.
Pneumonia in children can be caused by viruses like RSV or bacteria like S. pneumoniae. Clinical features include fever, cough, respiratory distress. Chest x-ray confirms diagnosis and shows lobar consolidation in bacterial pneumonia. Treatment involves antibiotics for bacterial cases. Children under 6 months, with severe distress, or not improving require hospitalization. Complications include pleural effusions, empyema, or hematologic spread causing meningitis.
Here are a few key points about painkiller overuse and addiction:
- Painkillers are highly effective medications for acute pain, but regular overuse can lead to addiction and dependence. The body develops a tolerance, requiring higher doses that may cause dangerous side effects.
- About 10% of Americans misuse or overuse prescription painkillers. This has contributed to a major public health crisis, as opioid overdoses have skyrocketed in recent years.
- It's easy to fall into the habit of reaching for a pill whenever minor headaches or other pains occur. However, this regular use changes how the brain and body respond to pain over time. Dependence and addiction may develop even when following dosage instructions.
1. Stridor is a high pitched noise caused by partial upper airway obstruction that is mainly inspiratory. Causes of stridor include laryngotracheobronchitis (croup), inhaled foreign bodies, epiglottitis, and laryngeal web.
2. Laryngotracheobronchitis (croup) most often affects children ages 6 months to 3 years and is caused by parainfluenza virus type 1. Symptoms include a barking cough and inspiratory stridor that worsens at night. Treatment involves humidified oxygen, nebulized epinephrine, and corticosteroids.
3. Acute epiglottitis is
Approach to Acute infective upper airway obstruction (infective stridor) in ...Jwan AlSofi
This lecture will discuss Approach to Acute infective upper airway obstruction (infective stridor) in children and paediatric age group.
Topics:-
Stridor
Stridor
croup,
Epiglottitis
laryngitis,
bacterial tracheitis
Retropharyngeal abscess
Spasmodic Croup
The document discusses laryngitis and vocal cord paralysis. Laryngitis is inflammation of the voice box that causes hoarseness and can be acute or chronic. It is usually caused by viral infection but long-term issues like smoking or acid reflux can lead to chronic laryngitis. Vocal cord paralysis occurs when the nerves controlling the vocal cords are damaged, preventing normal movement and function. Both conditions impact voice and breathing and may require treatments like voice therapy, injections, or surgery to improve symptoms. Accurate diagnosis involves laryngoscopy and other exams to determine the cause and appropriate treatment plan.
Acute otitis media and mastoiditis are infectious processes of the middle ear and mastoid air cells. Common bacteria include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Acute otitis media symptoms include fever, otalgia, and hearing loss. Physical exam may show bulging of the tympanic membrane. Treatment involves antibiotics for 5-10 days. Acute mastoiditis causes otalgia, fever, and postauricular swelling. Imaging shows bone rarefaction. Treatment requires intravenous antibiotics and may require mastoidectomy.
This document provides an overview of pneumonia, including its definition, classification, causes, transmission, risk factors, symptoms, diagnostic tests, treatment, nursing care, prevention, prognosis, and complications. Pneumonia is defined as an inflammatory condition of the lungs caused by infectious agents. It can be classified according to its causes such as bacterial, viral, fungal, or chemical, and the area of lung involvement. Common symptoms include fever, cough, chest pain, and shortness of breath. Diagnosis involves medical history, physical exam, chest x-ray, and sputum/blood tests. Treatment consists of antibiotics, oxygen therapy, and chest physiotherapy. Nursing care focuses on airway maintenance, infection control, respiratory support,
2. CauseCause
Congenital laryngeal stridor is a defectCongenital laryngeal stridor is a defect
that is present at birth. During fetalthat is present at birth. During fetal
development, the structures in the larynxdevelopment, the structures in the larynx
may not fully develop.may not fully develop.
3. CauseCause
As a result, there is a weakness in theseAs a result, there is a weakness in these
structures at birth, causing them tostructures at birth, causing them to
collapse during breathing. In children,collapse during breathing. In children,
congenital laryngeal stridor is the mostcongenital laryngeal stridor is the most
common cause of chronic stridor. Sixtycommon cause of chronic stridor. Sixty
percent of infants born with congenitalpercent of infants born with congenital
laryngeal stridor will have symptoms in thelaryngeal stridor will have symptoms in the
first week of life. Most other infants willfirst week of life. Most other infants will
show symptoms by 5 weeks old.show symptoms by 5 weeks old.
4. symptomssymptoms
The major symptom of this disorder is the stridorThe major symptom of this disorder is the stridor
that is heard as the infant breathes. The stridorthat is heard as the infant breathes. The stridor
is usually heard when the infant breathes inis usually heard when the infant breathes in
(inspiration), but can also be heard when the(inspiration), but can also be heard when the
infant breathes out (expiration). Otherinfant breathes out (expiration). Other
characteristics of the stridor may include:characteristics of the stridor may include:
The stridor changes with activity.The stridor changes with activity.
The stridor is usually less noisy when the child isThe stridor is usually less noisy when the child is
laying on his/her stomach.laying on his/her stomach.
The stridor gets worse if the infant has an upperThe stridor gets worse if the infant has an upper
respiratory infection.respiratory infection.
5. diagnosediagnose
a complete medical historya complete medical history
and physical examinationand physical examination
bronchoscopy of the airways - a procedurebronchoscopy of the airways - a procedure
which involves a tube being passed intowhich involves a tube being passed into
the airways to allow your child's physicianthe airways to allow your child's physician
to observe the airways during breathing.to observe the airways during breathing.
6. Treatment for congenitalTreatment for congenital
laryngomalacialaryngomalacia
Follow upFollow up
In most cases, congenital laryngeal stridor is a harmlessIn most cases, congenital laryngeal stridor is a harmless
condition that resolves on its own, without medicalcondition that resolves on its own, without medical
intervention. The condition usually improves by the timeintervention. The condition usually improves by the time
the infant is 18 months old and has no long-termthe infant is 18 months old and has no long-term
complications. In some cases, the stridor is apparentcomplications. In some cases, the stridor is apparent
until about the age of 5. Each child's case is unique.until about the age of 5. Each child's case is unique.
SurgerySurgery
A small percentage develop severe respiratory problemsA small percentage develop severe respiratory problems
which require medical and surgical interventions.which require medical and surgical interventions.
9. Laryngitis is an inflammation of the vocalLaryngitis is an inflammation of the vocal
cords causing speech to become hoarsecords causing speech to become hoarse
and/or whisperlike, and often inaudible.and/or whisperlike, and often inaudible.
10.
11. CauseCause
Viruses -- Influenza A and B, Adenovirus, Parainfluenza, andViruses -- Influenza A and B, Adenovirus, Parainfluenza, and
Rhinovirus are some of the viruses that may cause this condition.Rhinovirus are some of the viruses that may cause this condition.
Bacteria such as Hemophilus influenzae, beta-hemolyticBacteria such as Hemophilus influenzae, beta-hemolytic
streptococcus, andstreptococcus, and
Moraxella catarrhalisMoraxella catarrhalis
Inhalation of smoke, chemicals, and excessive use of voiceInhalation of smoke, chemicals, and excessive use of voice
AcidAcid RefluxReflux
AllergiesAllergies
AgingAging
14. Viral laryngitisViral laryngitis
General fatigueGeneral fatigue
MalaiseMalaise
Low-grade feverLow-grade fever
General body achesGeneral body aches
CoughCough
HoarsenessHoarseness
Sore throatSore throat
Dry throatDry throat
15. allergic laryngitisallergic laryngitis
Hoarseness that is worse during and severalHoarseness that is worse during and several
hours after exposure to the allergenhours after exposure to the allergen
Itchy throatItchy throat
Excess phlegm or mucous in the throatExcess phlegm or mucous in the throat
Feeling of dry throatFeeling of dry throat
CoughCough
Itchy sensation in the throatItchy sensation in the throat
SneezingSneezing
16. diagnosediagnose
Throat check for pharyngitis (infection)Throat check for pharyngitis (infection)
Neck checked for stridor (wheezing soundNeck checked for stridor (wheezing sound
heard by stethoscope)heard by stethoscope)
17. TreatmentTreatment
Avoid loud speech, such as shouting or singingAvoid loud speech, such as shouting or singing
Humidifiers (cool mist better) and steam (cool to warm, not hot) can help.Humidifiers (cool mist better) and steam (cool to warm, not hot) can help.
Avoid smoking, recreational drugs, and alcoholAvoid smoking, recreational drugs, and alcohol
Increase fluidsIncrease fluids
If severe, physicians will often instruct a person not to speak at all for theIf severe, physicians will often instruct a person not to speak at all for the
next few days.next few days.
If Hemophilus influenza or Moxarella catarrhalis are suspected, antibioticsIf Hemophilus influenza or Moxarella catarrhalis are suspected, antibiotics
will most likely be prescribed.will most likely be prescribed.
Symptoms usually resolve in fewer than seven days in most individuals.Symptoms usually resolve in fewer than seven days in most individuals.
18. TreatmentTreatment
If severe, physicians will often instruct a personIf severe, physicians will often instruct a person
not to speak at all for the next few days.not to speak at all for the next few days.
If Hemophilus influenza or Moxarella catarrhalisIf Hemophilus influenza or Moxarella catarrhalis
are suspected, antibiotics will most likely beare suspected, antibiotics will most likely be
prescribed.prescribed.
Symptoms usually resolve in fewer than sevenSymptoms usually resolve in fewer than seven
days in most individuals.days in most individuals.
21. DefinationDefination
Laryngitis is an inflammation of the larynx, theLaryngitis is an inflammation of the larynx, the
"voice box" that contains the vocal cords in the"voice box" that contains the vocal cords in the
upper portion of the neck. Laryngitis occurs inupper portion of the neck. Laryngitis occurs in
two forms, acute and chronic. Acute laryngitistwo forms, acute and chronic. Acute laryngitis
typically is a brief illness producing hoarsenesstypically is a brief illness producing hoarseness
and a sore throat. In most cases, an upperand a sore throat. In most cases, an upper
respiratory tract infection causes it. Chronicrespiratory tract infection causes it. Chronic
laryngitis is a more persistent disorder thatlaryngitis is a more persistent disorder that
produces lingering hoarseness and other voiceproduces lingering hoarseness and other voice
changes. It usually is painless and has nochanges. It usually is painless and has no
significant sign of infection.significant sign of infection.
22. CauseCause
Cigarette smoke is chronically irritatingCigarette smoke is chronically irritating
to the laryngeal mucosa. At theto the laryngeal mucosa. At the
extreme, it can provoke cancer.extreme, it can provoke cancer.
Ethanol contains many impurities, suchEthanol contains many impurities, such
as mycotoxins, tannins, aldehydes, andas mycotoxins, tannins, aldehydes, and
pesticides, which may cause cancer,pesticides, which may cause cancer,
either by direct contact with theeither by direct contact with the
mucosa or through a systemic effect,mucosa or through a systemic effect,
or may act as an irritant.or may act as an irritant.
23. Gastroesophageal reflux diseaseGastroesophageal reflux disease
InfectionsInfections
The bacterium most commonly isolated in chronicThe bacterium most commonly isolated in chronic
infectious laryngitis isinfectious laryngitis is Staphylococcus aureus.Staphylococcus aureus.
Haemophilus influenzaeHaemophilus influenzae and pneumococcal speciesand pneumococcal species
may complicate the course of viral laryngitis.may complicate the course of viral laryngitis.
Tuberculosis, caused by infection with the tubercleTuberculosis, caused by infection with the tubercle
bacillusbacillus Mycobacterium tuberculosis hominis,Mycobacterium tuberculosis hominis, was awas a
common disease of the larynx. Overall incidence hascommon disease of the larynx. Overall incidence has
declined. The hematogenous route and the infecteddeclined. The hematogenous route and the infected
sputum from pulmonary tuberculosis are the mostsputum from pulmonary tuberculosis are the most
likely sources of infection.likely sources of infection.
24. Voice abuse can be pertinent to professionalVoice abuse can be pertinent to professional
singers and to occasional shouters. Lesionssingers and to occasional shouters. Lesions
can range from simple edema, in thecan range from simple edema, in the
occasional abuser, to hyperplastic reactionsoccasional abuser, to hyperplastic reactions
if the stimuli persist over time.if the stimuli persist over time.
Allergic responses of immediate or delayedAllergic responses of immediate or delayed
hypersensitivity types can cause chronichypersensitivity types can cause chronic
laryngitis. Although the authors found nolaryngitis. Although the authors found no
data quantifying the exact number of peopledata quantifying the exact number of people
affected, current thought seems to indicateaffected, current thought seems to indicate
an increasing prevalence.an increasing prevalence.
25. Environmental factors, such as dust,Environmental factors, such as dust,
fumes, chemicals, and toxins, canfumes, chemicals, and toxins, can
cause this condition.cause this condition.
Systemic diseases, mostlySystemic diseases, mostly
autoimmune, may cause chronicautoimmune, may cause chronic
laryngitis.laryngitis.
Wegener granulomatosis.Wegener granulomatosis.
Amyloidosis.Amyloidosis.
Relapsing polychondritis.Relapsing polychondritis.
26. Chronic laryngitis may be associated withChronic laryngitis may be associated with
cutaneous diseases.cutaneous diseases. The larynx and theThe larynx and the
skin share similar microcharacteristicsskin share similar microcharacteristics
and macrocharacteristics.and macrocharacteristics.
27. Neurologic causes may contribute to chronic laryngitis.Neurologic causes may contribute to chronic laryngitis.
Spastic dysphonia is a discrete vocal disorder characterized bySpastic dysphonia is a discrete vocal disorder characterized by
strained, choked vocal attacks (laryngeal stuttering). The onsetstrained, choked vocal attacks (laryngeal stuttering). The onset
usually follows a stressful period in middle life. This conditionusually follows a stressful period in middle life. This condition
is probably a vocal expression of psychoneurotic behavior or ais probably a vocal expression of psychoneurotic behavior or a
CNS and/or proprioceptive disorder of the larynx.CNS and/or proprioceptive disorder of the larynx.
Vocal folds atrophy and lose tension with age, causingVocal folds atrophy and lose tension with age, causing
changes in phonation. Loss of thyroarytenoid ligamentchanges in phonation. Loss of thyroarytenoid ligament
elasticity results in breathiness and loss of breath supportelasticity results in breathiness and loss of breath support
because of bowed vocal folds.because of bowed vocal folds.
Muscular disorders may contribute to chronic laryngitis.Muscular disorders may contribute to chronic laryngitis.
Weakness of the larynx and the pharynx is present in one thirdWeakness of the larynx and the pharynx is present in one third
of patients with myasthenia gravis.of patients with myasthenia gravis.
28. symptomssymptoms
HoarsenessHoarseness
Sore throatSore throat
Weak or absent voiceWeak or absent voice
Sensation of a lump in the throat orSensation of a lump in the throat or
constant need to clear the throatconstant need to clear the throat
Dry coughDry cough
FeverFever
29. diagnosediagnose
Diagnosis is based upon a combination ofDiagnosis is based upon a combination of
the clinical history and a physical exam.the clinical history and a physical exam.
Some physicians might wish to do aSome physicians might wish to do a
laryngoscopy (visualization of the vocallaryngoscopy (visualization of the vocal
cords).cords).
30. TreatmentTreatment
IfIf laryngitislaryngitis is caused by a bacterial infection, antibioticsis caused by a bacterial infection, antibiotics
will be prescribed.will be prescribed.
Some palliative measures that can be taken include:Some palliative measures that can be taken include:
Avoid public speaking during recoveryAvoid public speaking during recovery
Be aware that whispering puts greater strain on theBe aware that whispering puts greater strain on the
vocal cords than normal speakingvocal cords than normal speaking
Inhale steam from a bowl of hot water or from a warmInhale steam from a bowl of hot water or from a warm
showershower
Drink warm, soothing liquids (but do not drinkDrink warm, soothing liquids (but do not drink
alcoholic beverages)alcoholic beverages)
Try a cool-mist humidifier; avoid air conditioningTry a cool-mist humidifier; avoid air conditioning
Use throat lozenges to ease the discomfortUse throat lozenges to ease the discomfort
Avoid cigarettes until the symptoms have subsidedAvoid cigarettes until the symptoms have subsided
33. Vocal cord disorders are often caused byVocal cord disorders are often caused by
vocal abuse or misuse, such as excessivevocal abuse or misuse, such as excessive
use of the voice when singing, talking,use of the voice when singing, talking,
smoking, coughing, yelling, or inhalingsmoking, coughing, yelling, or inhaling
irritants. Some of the more common vocalirritants. Some of the more common vocal
cord disorders include laryngitis, vocalcord disorders include laryngitis, vocal
nodules, vocal polyps, and vocal cordnodules, vocal polyps, and vocal cord
paralysis.paralysis.
34. vocal nodulesvocal nodules ANDAND vocal polypsvocal polyps
Vocal nodulesVocal nodules are benign (non-cancerous)are benign (non-cancerous)
growths on the vocal cords caused by vocalgrowths on the vocal cords caused by vocal
abuse. Vocal nodules are a frequent problem forabuse. Vocal nodules are a frequent problem for
professional singers. The nodules are small andprofessional singers. The nodules are small and
callous-like and usually grow in pairs (one oncallous-like and usually grow in pairs (one on
each cord). The nodules usually form on areaseach cord). The nodules usually form on areas
of the vocal cords that receive the most pressureof the vocal cords that receive the most pressure
when the cords come together and vibratewhen the cords come together and vibrate
(similar to the formation of a callous). Voice(similar to the formation of a callous). Voice
nodules cause the voice to be hoarse, low, andnodules cause the voice to be hoarse, low, and
breathy.breathy.
35. vocal nodulesvocal nodules ANDAND vocalvocal
polypspolyps
A vocal polypA vocal polyp is a soft, benign (non-cancerous)is a soft, benign (non-cancerous)
growth, similar to a blister. A polyp usually growsgrowth, similar to a blister. A polyp usually grows
alone on one vocal cord and is often caused byalone on one vocal cord and is often caused by
long-term cigarette smoking. Other causes oflong-term cigarette smoking. Other causes of
vocal polyps include hypothyroidismvocal polyps include hypothyroidism
(underactive thyroid gland), gastroesophageal(underactive thyroid gland), gastroesophageal
reflux, and continuous voice misuse. Voicereflux, and continuous voice misuse. Voice
polyps cause the voice to be hoarse, low, andpolyps cause the voice to be hoarse, low, and
breathy. Vocal polyps are also called Reinke'sbreathy. Vocal polyps are also called Reinke's
edemas or polypoid degeneration.edemas or polypoid degeneration.
36. CAUSESCAUSES
vocal trauma (more specifically,vocal trauma (more specifically,
phonotrauma in the case of vocal foldphonotrauma in the case of vocal fold
polyps and vocal fold nodules)polyps and vocal fold nodules)
37. symptomssymptoms
a voice change. Typical presentinga voice change. Typical presenting
symptoms include generalized andsymptoms include generalized and
persistent hoarseness, change in voicepersistent hoarseness, change in voice
quality, and increased effort in producingquality, and increased effort in producing
the voice. The laryngeal examination maythe voice. The laryngeal examination may
show either unilateral or bilateral lesions.show either unilateral or bilateral lesions.
38. diagnosediagnose
Any hoarseness or change in voice that lastsAny hoarseness or change in voice that lasts
longer than two weeks should be brought to thelonger than two weeks should be brought to the
attention of your physician. (Sometimes theattention of your physician. (Sometimes the
hoarseness may be indicative of laryngealhoarseness may be indicative of laryngeal
cancer.)cancer.)
a complete medical history and physicala complete medical history and physical
examinationexamination
examine the vocal cords internally with a small,examine the vocal cords internally with a small,
long-handled mirror (indirect laryngoscopy) orlong-handled mirror (indirect laryngoscopy) or
laryngoscopylaryngoscopy
39. TreatmentTreatment
eliminating the behavior that caused theeliminating the behavior that caused the
vocal cord disordervocal cord disorder
a referral to a speech-languagea referral to a speech-language
pathologist who has specialized training inpathologist who has specialized training in
treating voice, speech, language, ortreating voice, speech, language, or
swallowing disorders that affectswallowing disorders that affect
communicationcommunication
medicationmedication
surgery to remove growthssurgery to remove growths
42. CauseCause
Laryngitis is a group of disorders in whichLaryngitis is a group of disorders in which
the inflammatory process covers thethe inflammatory process covers the
mucous membrane of all or particularmucous membrane of all or particular
levels of the larynx.levels of the larynx.
These disorders have a different course inThese disorders have a different course in
children under 4 years old than in childrenchildren under 4 years old than in children
above 4 years old.above 4 years old.
WHY?WHY?
43. specific variations of the structure ofspecific variations of the structure of
the larynx in children under 4 yearsthe larynx in children under 4 years
old AND above 4 years oldold AND above 4 years old
The larynx of a small child is located higher,The larynx of a small child is located higher,
and the mucous is thicker and contains aand the mucous is thicker and contains a
large amount of soft tissue. This soft tissue islarge amount of soft tissue. This soft tissue is
mainly located under the mucous of themainly located under the mucous of the
aryepiglottic folds, and especially in thearyepiglottic folds, and especially in the
subglottic region.subglottic region.
44. The specific reactivity of the mucousThe specific reactivity of the mucous
membrane in small children makes themmembrane in small children makes them
prone to infections, especially viral. Some ofprone to infections, especially viral. Some of
these infections may cause oedema of thethese infections may cause oedema of the
mucus. The respiratory tract in children ismucus. The respiratory tract in children is
relatively narrow in this region and therelatively narrow in this region and the
chondrous ring limits the size of the subglotticchondrous ring limits the size of the subglottic
region. So, oedema in this region may have aregion. So, oedema in this region may have a
dramatic course, leading even to acutedramatic course, leading even to acute
respiratory distressrespiratory distress
47. diagnosediagnose
general examinationsgeneral examinations
laryngological examinationslaryngological examinations
direct visualization of the larynxdirect visualization of the larynx
endoscopy, fiberoscopy and laryngoscopyendoscopy, fiberoscopy and laryngoscopy
48. Differential diagnosisDifferential diagnosis
Foreign body of the larynx :Foreign body of the larynx :
The most general symptoms of laryngitis occur alsoThe most general symptoms of laryngitis occur also
in other disorders of the larynx which occur within other disorders of the larynx which occur with
dyspnoea like the foreign body of the larynx. So thedyspnoea like the foreign body of the larynx. So the
precise diagnosis is a good base for planning of furtherprecise diagnosis is a good base for planning of further
treatment.treatment.
Congenital defect of the larynx:Congenital defect of the larynx:
When the symptoms of laryngitis occur at under 6When the symptoms of laryngitis occur at under 6
months of age or are prolonged or recurrent, amonths of age or are prolonged or recurrent, a
congenital defect of the larynx should be suspected, i.e.congenital defect of the larynx should be suspected, i.e.
laryngeal web or haemangioma of the larynx. In theselaryngeal web or haemangioma of the larynx. In these
cases direct examination of the larynx is an urgentcases direct examination of the larynx is an urgent
necessity, because the treatment of these disordersnecessity, because the treatment of these disorders
varies.varies.
49. TreatmentTreatment
HospitaliseHospitalise
systemic anti-inflammatory drugs,systemic anti-inflammatory drugs,
humidification and cooling the air in the room.humidification and cooling the air in the room.
hydrocortisone in high dose (10 mg per kg b. w.), preferably i.v., mayhydrocortisone in high dose (10 mg per kg b. w.), preferably i.v., may
be necessary.be necessary.
Intubation:Only intubation is a good method which protects the childIntubation:Only intubation is a good method which protects the child
from asphyxiation.from asphyxiation.
Formerly, tracheotomy was performed, but now it is not oftenFormerly, tracheotomy was performed, but now it is not often
performed in this disease.performed in this disease.
Antibiotics are administrated in those patients in whom bacterialAntibiotics are administrated in those patients in whom bacterial
complications develop. It should be underlined that the antibioticscomplications develop. It should be underlined that the antibiotics
given for uncomplicated laryngitis in small children do not bringgiven for uncomplicated laryngitis in small children do not bring
improvement, so should be avoided.improvement, so should be avoided.
In patients older than 4 years of age etiologic factors may beIn patients older than 4 years of age etiologic factors may be
different e.g. allergy. In these cases administration of anti-histaminicdifferent e.g. allergy. In these cases administration of anti-histaminic
drugs and calcium may be suitable.drugs and calcium may be suitable.
52. DefinitionDefinition
A very rapidly progressive infectionA very rapidly progressive infection
causing inflammation of the epiglottis (thecausing inflammation of the epiglottis (the
flap that covers the trachea) and tissuesflap that covers the trachea) and tissues
around the epiglottis that may lead toaround the epiglottis that may lead to
abrupt blockage of the upper airway andabrupt blockage of the upper airway and
death.death.
53. CauseCause
Infection:Infection:
H influenzaeH influenzae
Haemophilus parainfluenzaeHaemophilus parainfluenzae
Streptococcus pneumoniae,Streptococcus pneumoniae, and group A streptococci.and group A streptococci.
Less common infectious bacteria (eg,Less common infectious bacteria (eg, StaphylococcusStaphylococcus
aureus,aureus, mycobacteria,mycobacteria, Bacteroides melaninogenicus,Bacteroides melaninogenicus,
Enterobacter cloacae, Escherichia coli,Enterobacter cloacae, Escherichia coli,
Fusobacterium necrophorum, KlebsiellaFusobacterium necrophorum, Klebsiella
pneumoniae, Neisseria meningitidis, Pasteurellapneumoniae, Neisseria meningitidis, Pasteurella
multocidamultocida),),
herpes simplex virus (HSV), other viruses, infectiousherpes simplex virus (HSV), other viruses, infectious
mononucleosis,mononucleosis, CandidaCandida (in immunocompromised(in immunocompromised
patients), andpatients), and AspergillusAspergillus (in immunocompromised(in immunocompromised
patients).patients).
54. Noninfectious factors:Noninfectious factors:
thermal causesthermal causes
crack cocaine smokingcrack cocaine smoking
marijuana smokingmarijuana smoking
throat burns affecting the epiglottis of bottle-fed infants)throat burns affecting the epiglottis of bottle-fed infants)
caustic insults (eg, automatic dishwasher soap ingestion)caustic insults (eg, automatic dishwasher soap ingestion)
foreign body ingestionforeign body ingestion
head and neck chemotherapy.head and neck chemotherapy.
Before widespread Hib vaccination,Before widespread Hib vaccination, H influenzaeH influenzae caused almostcaused almost
all pediatric cases.all pediatric cases.
AllergyAllergy
55. symptomssymptoms
Sore throat (95%)Sore throat (95%)
Odynophagia/dysphagia (95%)Odynophagia/dysphagia (95%)
Muffled voice (54%)Muffled voice (54%)
Usually, no prodromal symptoms occurUsually, no prodromal symptoms occur
in children. Adults may have precedingin children. Adults may have preceding
upper respiratory infection (URI)upper respiratory infection (URI)
symptoms.symptoms.
56. General symptomsGeneral symptoms
FeverFever
Drooling/inability to handle secretionsDrooling/inability to handle secretions
Cervical adenopathyCervical adenopathy
Stridor - A late finding indicating advanced airway obstructionStridor - A late finding indicating advanced airway obstruction
Muffled voice (54%)Muffled voice (54%)
Tripod position - Sitting up on hands with the tongue out and the headTripod position - Sitting up on hands with the tongue out and the head
forwardforward
HypoxiaHypoxia
Respiratory distressRespiratory distress
Severe pain on gentle palpation over the larynxSevere pain on gentle palpation over the larynx
Mild coughMild cough
FeverFever
IrritabilityIrritability
TachycardiaTachycardia
Toxic appearance of patientToxic appearance of patient
57. diagnosediagnose
Differential DiagnosesDifferential Diagnoses
Peritonsillar AbscessPeritonsillar Abscess
Retropharyngeal AbscessRetropharyngeal Abscess
Toxicity, Caustic IngestionsToxicity, Caustic Ingestions
Other Problems to Be ConsideredOther Problems to Be Considered
Airway obstructionAirway obstruction
Foreign body aspirationForeign body aspiration
Bacterial laryngotracheobronchitisBacterial laryngotracheobronchitis
LaryngotracheobronchopneumonitisLaryngotracheobronchopneumonitis
Retropharyngeal abscessRetropharyngeal abscess
Peritonsillar abscessPeritonsillar abscess
LaryngitisLaryngitis
Laryngeal diphtheriaLaryngeal diphtheria
Caustic ingestionsCaustic ingestions
Acute angioedemaAcute angioedema
SepsisSepsis
61. CauseCause
Most common benign tumor of the larynxMost common benign tumor of the larynx
and occurs in patients of all age.and occurs in patients of all age.
The causative agent is thought to be HPV.The causative agent is thought to be HPV.
Papillomas usually regress during puberty.Papillomas usually regress during puberty.
62. CauseCause
Usually involving the true vocal cords butUsually involving the true vocal cords but
may affect supraglottic and subglotticmay affect supraglottic and subglottic
regions.regions.
May also involve the trachea andMay also involve the trachea and
bronchus.bronchus.
63. CauseCause
Papillomas in juveniles is more oftenPapillomas in juveniles is more often
multiple and recurs more frequently thanmultiple and recurs more frequently than
in adults.in adults.
Papillomas in adults are usually single butPapillomas in adults are usually single but
may undergo malignant change (may undergo malignant change (HPV 16HPV 16 ,,
1818).).
64. symptomssymptoms
Aphonia or weak cry is usually the firstAphonia or weak cry is usually the first
sign in infants.sign in infants.
Dyspnea and stridor are seen.Dyspnea and stridor are seen.
Hoarseness is the most commonHoarseness is the most common
symptom in adults.symptom in adults.
65. diagnosediagnose
Laryngoscopic examinationLaryngoscopic examination ::
the tumor is pink or dark red in color. Thethe tumor is pink or dark red in color. The
surface of the tumor is rough andsurface of the tumor is rough and
papillary. The tumor is located in VC, falsepapillary. The tumor is located in VC, false
VC or subglottic area.VC or subglottic area.
66. TreatmentTreatment
⑴⑴ excision under microlaryngoscopy is the mostexcision under microlaryngoscopy is the most
commonly employed treatment modality.commonly employed treatment modality.
Repeated operations are usually needed inRepeated operations are usually needed in
children.children.
Co2 laser is favored because of its hemostaticCo2 laser is favored because of its hemostatic
properties and its precision allows forproperties and its precision allows for
vaporization of the lesion.vaporization of the lesion.
67. TreatmentTreatment
⑵⑵ Tracheotomy is occasionally indicatedTracheotomy is occasionally indicated
in children with dyspnea, but should bein children with dyspnea, but should be
avoided due to concern about subglotticavoided due to concern about subglottic
spread.spread.
68. TreatmentTreatment
⑶⑶ transfer factor, interferon andtransfer factor, interferon and
antivirotics.antivirotics. Cidofovir , a new antiviral agentCidofovir , a new antiviral agent
approved for ocular cytomegalovirus infections,approved for ocular cytomegalovirus infections,
has shown promise as a local injection inhas shown promise as a local injection in
adjuvant therapy.adjuvant therapy.
⑷⑷ Autogenous vaccine.Autogenous vaccine.
71. EpidemiologyEpidemiology
Accounts for 1% of all new cancers diagnosed in theAccounts for 1% of all new cancers diagnosed in the
U.S. and 0.75% of all cancer deaths.U.S. and 0.75% of all cancer deaths.
Accounts for 30% in all head and neck cancers.Accounts for 30% in all head and neck cancers.
More frequently happened in patients at 50~70 years ofMore frequently happened in patients at 50~70 years of
age.age.
M:F ratio: 5~10:1 (foreign country)M:F ratio: 5~10:1 (foreign country) ,, 6.75:1(shanghai).6.75:1(shanghai).
72. EtiologyEtiology
CigaretteCigarette
Wine (combined smoking and alcohol abuseWine (combined smoking and alcohol abuse
increases the risk by 50% over the additive rate )increases the risk by 50% over the additive rate )
air pollutionair pollution
Virus (HPV)Virus (HPV)
precancerous lesions (precancerous lesions (Leukoplakia, PapillomaLeukoplakia, Papilloma))
sex hormonessex hormones
73. PathologyPathology
Nearly 98% are squamous cell carcinoma.Nearly 98% are squamous cell carcinoma.
adenocarcinoma and undifferentiatedadenocarcinoma and undifferentiated
carcinoma is rare.carcinoma is rare.
74. Clinical classification:Clinical classification:
Glottic (60%)Glottic (60%) :: well differentiated, latewell differentiated, late
metastasismetastasis
Supraglottic (30%)Supraglottic (30%) :: poor differntiated,poor differntiated,
early metastasisearly metastasis
Subglottic (6%)Subglottic (6%) :: poor differentiated,poor differentiated,
early metastasisearly metastasis
75. Spread of tumorSpread of tumor
⒈⒈ Direct spreadDirect spread
Supraglottic cancer→ epiglottis, pre-①Supraglottic cancer→ epiglottis, pre-①
epiglottic space, vallecula, and tongueepiglottic space, vallecula, and tongue
base. piriform sinus, lateral wall of②base. piriform sinus, lateral wall of②
hypopharynx. paraglottic space,③hypopharynx. paraglottic space,③
ventricle or the VC.ventricle or the VC.
76. Spread of tumorSpread of tumor
Glottic cancer→ anteriorly, contralateral①Glottic cancer→ anteriorly, contralateral①
VC. posteriorly, arytenoid cartilage② ③VC. posteriorly, arytenoid cartilage② ③
superiorly, supraglottic area. inferiorly,④superiorly, supraglottic area. inferiorly,④
paraglottic space and subglottic area.paraglottic space and subglottic area.
77. Spread of tumorSpread of tumor
Subglottic cancer→ superiorly, glottis.①Subglottic cancer→ superiorly, glottis.①
anteriorly and laterally, strap muscle② anteriorly and laterally, strap muscle②
and thyroid gland. posteriorly,③and thyroid gland. posteriorly,③
esophagus.esophagus.
78. Spread of tumorSpread of tumor
⒉⒉ Lymph nodes metastasesLymph nodes metastases
Supraglottic cancer →have a propensity toSupraglottic cancer →have a propensity to
spread to cervical lymph nodes bilaterallyspread to cervical lymph nodes bilaterally
at the early stages.at the early stages.
Generally, the risk of occult or actualGenerally, the risk of occult or actual
metastases from T1, T2, T3 and T4metastases from T1, T2, T3 and T4
tumors is 20, 40, 60, and 80%.tumors is 20, 40, 60, and 80%.
79. Spread of tumorSpread of tumor
Glottic cancer →CV is virtually devoid ofGlottic cancer →CV is virtually devoid of
lymphatics, involvement of cervical nodeslymphatics, involvement of cervical nodes
at the early stages is not common.at the early stages is not common.
<< 8% of patients with T1 and T2 tumors8% of patients with T1 and T2 tumors
will have nodal involvement.will have nodal involvement.
80. Spread of tumorSpread of tumor
Glottic cancer →Only at the later stages,Glottic cancer →Only at the later stages,
prelaryngeal nodes, paratracheal nodesprelaryngeal nodes, paratracheal nodes
and other cervical nodes could beand other cervical nodes could be
involved.involved.
81. Spread of tumorSpread of tumor
Subglottic cancer →tend to spread toSubglottic cancer →tend to spread to
paratracheal lymphatics and then toparatracheal lymphatics and then to
superior mediastinual nodes.superior mediastinual nodes.
82. Spread of tumorSpread of tumor
⒊⒊ Distant metstases via bloodDistant metstases via blood
Distant metastasis only occurs in the veryDistant metastasis only occurs in the very
later stage of laryngeal carcinoma .later stage of laryngeal carcinoma .
83. symptomssymptoms
Supraglottic carcinomaSupraglottic carcinoma ::
Might be asymptomaticMight be asymptomatic
Foreign body sensationForeign body sensation
Pain while swallowingPain while swallowing
Throat burnsThroat burns
Enlargement of cervical lymph nodesEnlargement of cervical lymph nodes
84. symptomssymptoms
Glottic carcinomaGlottic carcinoma ::
Hoarsenenss is the early symptomHoarsenenss is the early symptom
Respiratory obstruction will happen in lateRespiratory obstruction will happen in late
stagestage
85. symptomssymptoms
SubgSubglottic carcinomalottic carcinoma ::
There are no definitive symptoms in theThere are no definitive symptoms in the
early stage.early stage.
Dyspnea and lymph nodes metastasis isDyspnea and lymph nodes metastasis is
the late symptomsthe late symptoms
86. diagnosediagnose
Physical examinationPhysical examination
Laryngoscopic examination can find aLaryngoscopic examination can find a
mass on one or both vocal cordsmass on one or both vocal cords
fixation of the vocal cords is commonfixation of the vocal cords is common
mass in the neckmass in the neck
87. Differential diagnosisDifferential diagnosis
Tuberculosis of the larynxTuberculosis of the larynx :: chest X-raychest X-ray
filmfilm
Papilloma of the larynxPapilloma of the larynx
Syphilis of the larynxSyphilis of the larynx
88. TreatmentTreatment
Early laryngeal carcinoma (T1/T2) is usuallyEarly laryngeal carcinoma (T1/T2) is usually
managed with single modality of treatment andmanaged with single modality of treatment and
responds well to radiation, transoral laserresponds well to radiation, transoral laser
resection,or partial laryngeal surgery.resection,or partial laryngeal surgery.
Primary cure rates of 80 to 85% are expected.Primary cure rates of 80 to 85% are expected.
89. TreatmentTreatment
The management of advanced laryngealThe management of advanced laryngeal
carcinoma is more controversial.carcinoma is more controversial.
The aim is to optimize disease-free andThe aim is to optimize disease-free and
overall survival while preserving quality ofoverall survival while preserving quality of
life.life.
90. TreatmentTreatment
Generally, combined therapy is widelyGenerally, combined therapy is widely
used, as it shows better survival rates thanused, as it shows better survival rates than
single-modality treatment.single-modality treatment.
Surgery + radiotherapy or radiotherapy +Surgery + radiotherapy or radiotherapy +
surgery are two commonly usedsurgery are two commonly used
modalities.modalities.
91. TreatmentTreatment
Partial laryngectomyPartial laryngectomy
Total laryngectomyTotal laryngectomy
Rehabilitation of speech after total laryngectomyRehabilitation of speech after total laryngectomy
Blom- Singer valveBlom- Singer valve
Esophageal speechEsophageal speech
Electrical larynxElectrical larynx
Neck dissectionNeck dissection
95. symptomssymptoms
inspiratory dyspneainspiratory dyspnea
inspiratory stridorinspiratory stridor
depression of suprasternal fossa,depression of suprasternal fossa,
intercostal and supraclavicular space orintercostal and supraclavicular space or
epigastrium while inspirationepigastrium while inspiration
hoarseness and even cyanosishoarseness and even cyanosis
96. classification:classification:
ⅠⅠ°°there is no symptoms at rest. But slightthere is no symptoms at rest. But slight
inspiratory dyspnea and stridor may occurinspiratory dyspnea and stridor may occur
during crying or on exertionduring crying or on exertion
97. classification:classification:
ⅡⅡ°°slight inspiratory dyspnea during quietslight inspiratory dyspnea during quiet
respiration, and exaggeration on exertion.respiration, and exaggeration on exertion.
Sleeping and taking the meal is nearlySleeping and taking the meal is nearly
normal , no evidence of hypoxia.normal , no evidence of hypoxia.
98. classification:classification:
ⅢⅢ°° :: with marked inspiratory dyspnea,with marked inspiratory dyspnea,
loud stridor, depression of suprasternalloud stridor, depression of suprasternal
and supraclavicular fossae and intercostaland supraclavicular fossae and intercostal
spaces, cyanosis, restless and strugglesspaces, cyanosis, restless and struggles
for air hunger, with quick pulse, high bloodfor air hunger, with quick pulse, high blood
pressure and refuse meals.pressure and refuse meals.
99. classification:classification:
ⅣⅣ°° :: extremely dyspneic, restless,extremely dyspneic, restless,
sweating, cyanoticsis. Pulse is rapid,sweating, cyanoticsis. Pulse is rapid,
irregular, weak and thready. B.P. drops.irregular, weak and thready. B.P. drops.
Finally circulatory collapse may occur orFinally circulatory collapse may occur or
may die of asphyxia or cardiac failure.may die of asphyxia or cardiac failure.
101. TreatmentTreatment
ⅡⅡ°° :: etiological treatment .etiological treatment .
in case of tumors of the larynx,in case of tumors of the larynx,
trauma, bilateral vocal cords paralysis,trauma, bilateral vocal cords paralysis,
tracheotomy is indicated.tracheotomy is indicated.
102. TreatmentTreatment
ⅢⅢ°° :: If the laryngeal obstruction is causedIf the laryngeal obstruction is caused
by inflammation, medical treatment can beby inflammation, medical treatment can be
administrated under close observation.administrated under close observation.
Tracheotomy should be prepared. IfTracheotomy should be prepared. If
dyspnea is not relieved, tracheotomydyspnea is not relieved, tracheotomy
should be performed immediately.should be performed immediately.
106. Tracheotomy is a surgical procedure inTracheotomy is a surgical procedure in
which an opening is made in the anteriorwhich an opening is made in the anterior
wall of the trachea to establish an airway.wall of the trachea to establish an airway.
107. Tracheotomy is often temporary andTracheotomy is often temporary and
reversible if the patient is able to breathereversible if the patient is able to breathe
through an unobstructed upper airwaythrough an unobstructed upper airway
109. IndicationIndication ::
⒈⒈ Laryngeal obstructionLaryngeal obstruction
⒉⒉ Secretion obstructed in lower respiratorySecretion obstructed in lower respiratory
tract (coma)tract (coma)
⒊⒊ Before some major head & neck surgeryBefore some major head & neck surgery
116. CCricothyrotomyricothyrotomy
Employed in first-aid cases.Employed in first-aid cases.
Making an opening in the membraneMaking an opening in the membrane
between the cricoid cartilage and thyroidbetween the cricoid cartilage and thyroid
cartilage and insert a cannula.cartilage and insert a cannula.
After the situation becomes stable,After the situation becomes stable,
ordinary tracheotomy should beordinary tracheotomy should be
performed.performed.