Disorders of larynx Flashcards
What is the clinical signifiance of the external branch of the superior laryngeal nerve being close to the superior thyroid artery?
May be injured in thyroid surgery
What is the sign of damage to external branch of the superior laryngeal nerve?
Hoarseness of voice
especially when attempting high pitched sounds
What is the clinical significance of the recurrent laryngeal artery being close to the inferior thyroid artery?
May be injured in thyroid surgery
What is the clinical signifiance of the recurrent laryngeal artery looping under the arch of the aorta?
May be damaged by aortic arch aneurysms
What is the clincal significance of the recurrent laryngeal artery being close to the apex of lung?
May be damaged by cancer in apex of lung
What are some benign causes of a hoarse voice?
Infection
Inflammation
Singer’s nodules
What are some concerning causes of a hoarse voice?
Damage to recurrent laryngeal nerve, external branch of superior laryngeal nerve
due to pathology in nearby structures, or pathology in larynx
What does damage to the recurrent laryngeal nerve cause?
Vocal cord palsy
What is the position of the vocal cord in a vocal cord palsy?
Paramedial position
so between abducted and adducted
What are the signs and symptoms of a unilateral vocal cord palsy?
Hoarse voice
Ineffective cough
What are the signs and symptoms of a bilateral vocal cord palsy?
Hoarse voice
Ineffective cough
Stridor
Why does a bilateral vocal cord palsy cause stridor but a unilateral vocal cord palsy doesn’t?
Bilateral vocal cord palsy
both vocal cords in paramedian position
narrow rima glottidis
significant airway obstruction
With unilateral vocal cord palsy rima glottidis has sufficient diameter for inspiration and expiration
How is a unilateral vocal cord palsy compensated for?
Other vocal cord crosses midline to meet non-functioning vocal cord
How is a bilateral vocal cord palsy managed?
Emergency
cricothyroidotomy or tracheatomy
How does the location of the carcinoma in the larynx affect prognosis? Why?
Glottis region has better prognosis
because poorer lymphatic drainage, so less likely to spread
Supra- and infra-glottis have worse prognosis
drain to pre-tracheal and neck lymph nodes
