This document discusses various laryngeal conditions including laryngomalacia, laryngeal cysts, laryngeal papillomatosis, laryngeal cancer, vocal cord nodules and polyps, and various causes of laryngeal injury and paralysis. It provides descriptions of the anatomical locations, presentations, causes, and potential treatments for each condition.

2.  Inflammation of tissues of subglottic space
 airway obstruction
 Aetiology; Parainfluenza
 Presentation; night, inspiratory/biphasic stridor,
barking cough

3.  Rare
 Causes
◦ Penetrating
◦ Blunt trauma
◦ Manual strangulation
◦ Inhaled flames
◦ Swallowed poisons, foreign body
 Injuries;
◦ Cricotracheal separation -> Asphyxia
◦ Fractures of larynx, hyoid bone, joint disruption
◦ Open wounds
◦ Mucosal Tears

4.  Most common congenital laryngeal anomaly.
 Accounts for approximately 60 percent of laryngeal
problems in the newborn.
 Boys are affected twice as often as girls.
 It is usually a self-limiting condition, but when
severe may produce:
◦ Life-threatening obstructive apnea,
◦ Cor pulmonale,
◦ Failure to thrive.
 Fatal outcomes have been described.
 Severe cases may require intubation or tracheotomy
to secure the airway.

5. Normal
Larynx
Laryngomalacia
The
supraglottic
structures
are pulled
into the
lumen
around a
vertical axis
with
inspiration
Collapse of
arytenoid
mucosa;
shortened
aryepiglottic
folds;
tubular
epiglottis
with
posterior
collapse

6.  Condition arises from a continued
immaturity of the larynx, as if the fetal
stage of laryngeal development has
persisted.
 Stridor is typically noted in the first few
weeks of life and is characterized by
fluttering, high-pitched inspiratory sounds.

7.  Dilated sac filled with air
(ventricle)
 Internal vs. external
 May present at birth–
stridor
 Endoscopic or open
procedures

8.  Extracellular
accumulation of
fibrillar proteins
 Systemic or localized
 Polypoid mass (glottis
and supraglottis) or
diffuse mucosal
swelling (subglottis)
 Hoarseness

9.  Trauma of mucosal
covering due to
vigorous glottal
closure
 Etiology: vocal abuse,
acid regurgitation, post
intubation trauma

10. ◦ A membrane extending from
one vocal fold to another
◦ Failure of recanalization of
larynx
◦ Four types– increasing
severity
◦ May present at birth
◦ Diagnosis: flexible
laryngoscopy
Laryngeal webs

11.  Vocal fold paralysis has long been recognized as
a significant cause of stridor and hoarseness in
infants and children.
 Laryngeal paralysis may be present at birth or
may manifest itself in the first month or two of life.
 The neurologic impairment reflects an injury to the
vagus nerve.

13.  The lesion can occur anywhere
from the brain through the neck into
the chest and into the larynx.
 The most common causative
factors include entities such as:
◦ Hydrocephalus, neonatal
hypotonia,
◦ Multiple peripheral paralysis
(myasthenia gravis).
◦ Other causes include birth trauma
and cardiac anomalies.
 .

14.  narrowing of the airway below the vocal cords
(subglottis) and above the trachea
 May be classified as either acquired or congenital.
 Congenital SGS is divided histopathologically into
membranous and cartilaginous types.
 Membranous SGS is usually circumferential and
consists of fibrous soft-tissue thickening.
 The cartilaginous type usually results from a thickened
or deformed cricoid cartilage

15.  The severity of congenital subglottic stenosis
depends on the degree of SG narrowing.

16.  Rare congenial anomaly
 congenital laryngeal anomaly occurs in 1 in 2000
live births, less than 0.3% attributable to laryngeal
cleft

17.  The term "laryngitis" is frequently misused as a
synonym for hoarseness, but "laryngitis" refers to
any acute or chronic, infectious or noninfectious,
localized or systemic inflammatory process that
involves the larynx, typically resulting in huskiness or loss of the
voice, harsh breathing, and a painful cough.

18.  Reactive nodules (singers nodules)
◦ Bilateral
◦ Smooth, rounded/pedunculated
◦ Small
◦ Located on true vocal folds
◦ Treatment;
 Voice training, re-education
 Rarely surgical if fibrosed, chronic
◦ Virtually never give rise to malignancy

19.  Acute Laryngitis present
with red, swollen cords,
usually cured by antibiotics
 Specific Chronic Laryngitis
- eg: Tubercolosis,
 Non-Specific Chronic
Laryngitis - usually caused
by smoking

20.  Most common benign neoplasm of larynx (84%)
 Found on true vocal cords
 Usually Single in Adults
 Multiple in Children (Laryngeal Papillomatosis)
with extended growth and recurrence
 Malignant transformation extremely rare

21.  Most common malignancy of larynx
 Cause is not know
 Malignant tumour
 Can grow on one or both vocal cords

22.  Vocal Cord Polyps –
protruding growth from
mucuous
membrane,cause
hoarseness and attacks of
coughing, surgical removal
 Reinke’s Edema -
swellingof the vocal folds
due to fluid collection
(edema) in superficial
lamina propria of vocal
folds (Reinke's space

23.  Papillomata- benign
epithelial tumor cause by
viral infection, usually
recurrent; usually occyr
between first and eight yrs
of life, causes dysphonia
and respiratory obstruction
 Retention cysts –any
closed cavity or sac
containing semisolid
material ,glazed, white
cysts derived from the
mucosal glands, effect
phonation

24.  Abnormal vocal cord
position - surgical
intervention eg:
medialisation
 Recurrent laryngeal nerve
paralysis - all the internal
laryngeal musculature is
paralysed on the affected
side. If the case is
bilateral, the glottis is
widened with CO2 laser
surgery

25.  Vocal Abuse - often leads to
formation of polyps and
nodules which are removed
surgically
 Intubation Injury -formation of
heamatoma - usually heals
by itself - or granulomas
which can be surgically
removed