Common Voice and Airway Disorders

Question 1

• any age, men and women
• invariably accompanied by a URI
• progressive worsening of voice over 72 hours
• can progress to Aphonia
• mostly they progress to dysphonia
• spontaneous resolution over another 4 days

Answer 1

adult laryngitis

Question 2

treatment of laryngitis?

Answer 2

• relative voice rest
• warm tea for hydration and secretion clearance
• a medrol dose pack is reasonable if the person is voice dependent

Question 3

• vocal overuse
• repetitive microtrauma to mid vocal folds
• closure and pliability
• reduce demands
• voice therapy
• surgery

Answer 3

Nodules

Question 4

• most common benign tumor of vcs
• pediatric and adult forms
• closure, pliability and symmetry
• voice and airway
• surgery- mechanical or laser debulking
• high risk of permanent dysphonia

Answer 4

papilloma

Question 5

• benign enlargment and alteration of golden layer
• adult female smokers
• closure, pliability and symmetry
• voice and airway
• office-based KTP laster or steroid injection
• return almost to normal

Answer 5

Reinke’s edema

Question 6

• atrophy of musculomembranous layers- bowing
• incompetent valve–> fatigue
• closure issue
• voice only affected
• voice therapy , office based injections to augment vocal cords, implants

Answer 6

presbylarynx

Question 7

when to refer with voice changes?

Answer 7

• voice change in a smoker
• acute voice change following yelling
• new hoarsness for more than four weeks
• unresolved hoarseness after laryngitis

Question 8

what is stridor?

Answer 8

• noisy upper airway breathing
• inspiratory stridor- breathing in
• expiratory stridor- breathing out
• biphasic stridor- both in and out
• stronger sound in the neck than the lungs with a stethescope

Question 9

• affects children 2-6 years old
• involves the supraglottic larynx
• fevers, chills, malaise
• rapidly progressive
• tripod stance, drooling
• manage in OR with intubation

HINT: Always ask about HIB vaccination

Answer 9

epiglottis

DX: lateral X-ray, rare to get or need CT of neck

Question 10

• laryngotracheobronchitis- 18mo-3 years
• lower airways involved
• barky cough and stridor
• conservative management- mist tent, steroids, intubation if all else fails

Answer 10

Croup

Question 10

• rare
• children or compromised adults
• cough/ choke event followed by quiet
• older siblings
• X-ray is only so helpful but get it because, batteries or button batteries are an emergency and must be removed

Answer 10

airway foreign body

Question 11

• congenital or acquired
• acquired from prolonged intubation
• biphasic or expiratory stridor
• worse with colds and exercise
• treatment with dilation or open surgery

Answer 11

subglottic stenosis

Question 12

• infectious process
• affect any part of the supraglottis
• fevers, chills, malaise, sore throat
• more indolent than pediatric version
• often managed without airway intervention
• antibiotics, steroids, serial exams

Answer 12

supraglottitis