Ppt by kunal singh

1. Diseases of the larynx: acute laryngitis;
acute laryngotracheitis; laryngeal edema;
laryngeal stenosis.
NAME – KUNAL SINGH
GROUP - GM20-148a
SUBJECT - ENT
TOPIC- 4

2. The larynx, or voice box, sits at the back
of the throat, above the windpipe
(trachea). It is supported by rings of
cartilage, which form the bump of the
Adam’s apple. The vocal cords are
stretchy bands of tissue attached to the
inside of the larynx. Air passing in and
out of the lungs is pushed through these
cords. Movements of the cartilage allow
the vocal cords to contract or relax,
which changes the pitch of sounds.
Other body parts that influence the
qualities of a person’s voice include the
nose, mouth, tongue, jaw and throat.
The larynx also contains an important
flap or valve called the epiglottis, which
covers the trachea whenever we swallow
to prevent foods or liquid entering the
lungs. Various infections and disorders,
such as cancer, can affect the larynx.
The usual symptom is hoarseness.
INTRODUCTION

3. Diseases of the Larynx
This is an example of a normal larynx. The true vocal
folds are pearly white, they meet in the midline on
phonation, and the surrounding structures are light pink.
As you view the following examples of diseases of the
larynx, you can compare them to this example.
•The larynx (voice box) contains the vocal cords, which allow
speech.
•Disorders of the larynx include laryngitis, croup, growths and
cancer.
•A common irritation to the larynx is voice abuse, which includes
• screaming, singing or shouting too much.

5. Acute laryngitis
Acute laryngitis is characterized by inflammation
and congestion of the larynx in the early stages. This
can encompass the supraglottic, glottic, or subglottic
larynx (or any combination thereof), depending on
the inciting organism. As the healing stage begins,
white blood cells arrive at the site of infection to
remove the pathogens. This process enhances vocal
cord edema and affects vibration adversely, changing
the amplitude, magnitude, and frequency of the
normal vocal fold dynamic. As the edema
progresses, the phonation threshold pressure can
increase. The generation of adequate phonation
pressure becomes more difficult, and the patient
develops phonatory changes both as a result of the
changing fluid-wave dynamics of the inflamed and
edematous tissue, but also as a result of both
conscious and unconscious adaptation to attempt to
mitigate these altered tissue dynamics.

6. Etiology
The etiology of acute laryngitis can be classified as either infectious or non-infectious.
The infectious form is more common and usually follows an upper respiratory tract
infection.
Viral agents such as rhinovirus, parainfluenza virus, respiratory syncytial virus,
coronavirus, adenovirus, and influenza are all potential etiologic agents (listed in roughly
descending order of frequency). It is possible for bacterial superinfection to occur in the
setting of viral laryngitis, this classically occurs approximately seven days after symptoms
begin.
The most commonly encountered bacterial organisms are Streptococcus
pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, in that order.
Exanthematous febrile illnesses such as measles, chickenpox, and whooping cough are
also associated with acute laryngitis symptoms, so it is prudent to obtain an accurate
immunization history.
Laryngitis caused by fungal infection is very rare in immunocompetent individuals, and
more often presents as chronic laryngitis in the immunocompromised or in patients using
inhaled steroid medications.

7. Epidemiology
Acute laryngitis can affect patients of any age, though is more common in the adult
population, usually affecting individuals aged 18 to 40, though it may be seen in children
as young as three. Isolated voice symptoms in children younger than three should prompt a
more thorough workup for additional pathology including vocal cord paralysis, GERD,
and neurodevelopmental conditions. Accurate incidence measurements of acute laryngitis
remain difficult to elucidate as this condition remains under-reported, with many patients
appropriately not seeking medical care for this often self-limited condition

8. Evaluation
Diagnosis is usually made via a very thorough history and physical examination.
Formal voice analysis and fiberoptic laryngoscopy can be used to confirm the
diagnosis in cases that are refractory to treatment or otherwise convoluted.
Stroboscopy may be relatively normal or may reveal asymmetry, aperiodicity, and
reduced mucosal wave patterns .
Further imaging or laboratory studies are not required unless an atypical pathogen or
neoplasm are suspected. Rarely, if the patient has exudate in the oropharynx or vocal
cords, culture may be indicated.

9. Treatment / Management
Treatment is often supportive in nature and depends on the severity of laryngitis.
•Voice rest: This is the single most important factor. Use of voice during laryngitis results in incomplete or delayed
recovery. Complete voice rest is recommended although it is almost impossible to achieve. If the patient needs to speak,
the patient should be instructed to use a "confidential voice;" that is, a normal phonatory voice at low volume without
whispering or projecting.l
•Steam Inhalation: Inhaling humidified air enhances moisture of the upper airway and helps in the removal of secretions
and exudates.
•Avoidance of irritants: Smoking and alcohol should be avoided. Smoking delays prompt resolution of the disease
process.
•Dietary modification: dietary restriction is recommended for patients with gastroesophageal reflux disease. This
includes avoiding caffeinated drinks, spicy food items, fatty food, chocolate, peppermint. Another important lifestyle
modification is the avoidance of late meals. The patient should have meals at least 3 hours before sleeping. The patient
should drink plenty of water. These dietary measures have been shown to be effective in classic GERD, though their
efficacy in LPR is disputed, they are often still employed.
•Medications: Antibiotics prescription for an otherwise healthy patient with acute laryngitis is currently unsupported;
however for high-risk patients and patients with severe symptoms antibiotics may be given. Some authors recommend
narrow-spectrum antibiotics only in the presence of identifiable gram stain and culture.

10. Differential Diagnosis
This includes:
•Spasmodic dysphonia
•Reflux laryngitis
•Chronic allergic laryngitis
•Epiglottitis
•Neoplasm
Prognosis
As this is often a self-limiting condition, it carries a good prognosis. If the patient completes
the recommended therapy, the prognosis for recovery to a premorbid level of phonation is
excellent. If vocal maladaptations have occurred, a course of speech therapy can resolve
these problems.

11. Acute laryngotracheitis
laryngotracheitis (ILT) is a respiratory disease almost exclusively of chickens. Infections in
turkeys and pheasants have been reported, but surveys have yielded no wild bird reservoir or
other domestic poultry reservoir (Cranshaw and Boycott, 1982). Based on this and the
knowledge that ILT apparently exhibits little antigenic heterogeneity, it has been proposed that
through proper husbandry practices and appropriate vaccination techniques the disease could
be eliminated from commercial poultry (Bagust and Johnson, 1998).
The virus is a member of the Alphaherpesvirinae subfamily and is identified taxonomically as
gallid herpesvirus I. The disease is almost exclusively respiratory, with no systemic
involvement.

12. Acute laryngotracheitis is an inflammation of both the larynx (voice box) and the
trachea (windpipe). It is often caused by a viral infection, such as the common
cold or influenza, and it can result in a range of symptoms, including:
Hoarseness: A hoarse or raspy voice is a common symptom.
Cough: Laryngotracheitis can lead to a persistent, dry cough.
Sore Throat: Individuals may experience a sore or scratchy throat.
Difficulty Breathing: Swelling in the airways can cause breathing difficulties,
particularly in children.
Fever: Some cases may be associated with a mild fever.
Wheezing: Wheezing, a high-pitched whistling sound when breathing, can occur
in severe cases.
Acute laryngotracheitis

19. laryngeal edema

20. Laryngeal edema is the swelling of the larynx (voice box) due to an accumulation of
fluid. It can be caused by various factors, such as infections, allergic reactions,
trauma, or underlying medical conditions. Laryngeal edema can be a medical
emergency because it can obstruct the airway and lead to breathing difficulties.
Laryngeal edema

25. laryngeal stenosis
Laryngeal stenosis refers to a narrowing of the larynx (voice box) or the airway within
the larynx. This narrowing can occur due to various factors, including scarring,
inflammation, injury, or congenital abnormalities. Laryngeal stenosis can lead to
breathing difficulties and voice changes.

28. Stridor: High-pitched, noisy breathing during inhalation.
Shortness of Breath: Difficulty breathing, especially during physical activity
.
Hoarseness: Changes in the voice, often becoming hoarse.
Cough: Chronic cough due to irritation.
SYMPTOMS

32. Thankyou
for your
Attention
 NAME – KUNAL SINGH
 GROUP - GM20-148a
 SUBJECT - ENT