CBM - The Throat

Question 1

The Throat

Laryngeal nodules

Answer 1

Laryngeal nodules-

• cause a breathy- harsh voice.
• Commonly found in professions which require the use of their voice such as teachers, singers, lawyers.
• Speech therapy may be required or surgery.

Question 2

The Throat

Reinke’s Oedema?

Answer 2

Reinke’s oedema:

• Collection of tissue fluid in the sub epithelial layer of the vocal cords.
• Associated with irritation to the vocal cords due to factors such as smoking, voice abuse, acid reflux and very rarely, hypothyroidism.
• Treatment: surgery

Question 3

The Throat

Acute Onset of Hoarseness?

Answer 3

Acute onset of hoarseness:

• Red flag in smokers. Any patient with a hoarse voice for over 6 weeks should be seen by an ENT surgeon.
• A harsh, deep and breathy voice maybe an indication of a mass on the vocal cord or a paralysed left cord secondary due to mediastinal disease such as bronchial carcinoma

Question 4

The Throat

Early Squamous Cell Carcinoma of the Larynx?

Answer 4

• Early Squamous cell carcinoma of the larynx has a good prognosis.
• Spread of the tumour may require a laryngectomy

Other features of laryngeal cancer include:

• Sixty percent of tumours occur in the glottis and present early with dysphonia
• glottic cancer has the most favourable prognosis of all forms of laryngeal cancer, as people tend to seek medical advice for chronic hoarseness, which is the most common early symptom
• other symptoms of laryngeal cancer may include pain or problems with swallowing (dysphagia). There can also be a lump in the neck, sore throat, earache, or a persistent cough.
• virtually all cancer of the larynx is squamous cell carcinoma.
• if detected early, the prognosis is excellent with a 90% 5 year cure rate
• overall survival rates are better than for oral or pharyngeal cancer, with nearly two-thirds of patients surviving for five years

Question 5

The Throat

Tonsillitis?

Answer 5

• Tonsillitis- Bacterial tonsillitis is most commonly caused by beta-haemolytic streptococcus usually self limiting,
• however, persistent tonsillitis may require prescribing antibiotics or even tonsillectomy in cases where its severely impairing the quality of life for the patient.