6 - ENT - Upper airway - Voice - Causes of voice change - Structural/neoplastic

Question 1

Laryngeal carcinoma - causes? symptoms? management?

Answer 1

smoking, genetic

progressive hoarseness/voice change, stridor, referred otalgia, dysphagia

radiotherapy, partial/total laryngectomy

Question 2

Laryngeal carcinoma - signs?

Answer 2

raised, thick irregular mass with leukoplakia and erythema
narrowing of airway
cervical lymphadenopathy

Question 3

4 benign lesions causing voice changes

Answer 3

nodules, polyps, reinke’s oedema, cycts

Question 4

Nodules - causes + management

Answer 4

voice abuse, reflux

voice therapy, surgical excision if unresponsive

Question 5

nodules - S+S

Answer 5

Sx - husky voice, worsens with use, loss of higher freq, peri-laryngeal discomfort

si - bilateral swellings (hourglass appearance)

Question 6

polyps - causes and mgmt

Answer 6

shouting when suffering with cold/reflux - more common in MEN

voice therapy, surgical excision

Question 7

polyps - S+S

Answer 7

Sx - husky voice, worsens with use, voice cuts out during speech, choking if LARGe

Si - unilateral, grey/haemorrhagic

Question 8

reinkes oedema - causes and mgmt

Answer 8

smoking, hypothyroidism, voice abuse, reflux

stop msoking, surgical reduction, mgmt of reflux, voice therapy

Question 9

reinkes oedema - S+S

Answer 9

Sx - deep pitched, gravelly voice, choking if severe

Si - bilateral grey/erythematous swellings along length of vocal fold

Question 10

Cysts - causes and mgmt

Answer 10

may follow laryngeal inflammation, or be congenital

surgical excision

Question 11

cysts - S+S

Answer 11

Sx - husky voice, pitch breaks, loss of vocal range, increased effort required

Si - unilateral nodular swelling