FN: The Larynx

Question 1

Functions

Answer 1

Phonation
Positive thoracic pressure
Respiration
Prevention of aspiration

Question 2

Laryngitis

Answer 2

Usually viral and self-limiting

Secondary bacterial infection may develop

Question 3

Laryngitis symptoms

Answer 3

Pain hoarseness and fever

Question 4

Laryngitis O/e

Answer 4

Redness and swellin gof the vocal cords

Question 5

Laryngitis Rx

Answer 5

Supportive

Pen V if necessary

Question 6

recurrent laryngeal nerve

Answer 6

Suppliers all intrinsic muscles of the larynx except for cricothyroideus - external branch of sup laryngeal Nerve

Responsible for ab- and ab-uction of vocal folds

Question 7

Symptoms of recurrent laryngeal N. Palsy

Answer 7

Hoarseness
“Breathy” voice with bovine cough
Repeated coughing from aspiration (reduce supraglottic sensation)
Extertional dyspnoea (narrow glottis)

Question 8

Recurrent laryngeal nerve palsy causes

Answer 8

1. 30% are cancers: larynx, thyroid, oesophagus, hypopharynx, bronchus
2. 25% iatrogenic: para-/thyroidectomy, carotid endarterectomy
3. OTher> aortic aneurysm, bulbar/pseudobulbar palsy

Question 9

Laryngeal SCC incidence and associations

Answer 9

2000/yr in uk

Associations: smoking, EtOH

Question 10

Laryngeal SCC presentation

Answer 10

Male smoker
Progressive hoarseness - stridor
Dys/odon-phagia
Wt. los

Question 11

Laryngeal SCC Investigations

Answer 11

Laryngoscopy + biopsy (inc. nodes)

MRI stagingLaryngeal SCC Mx

Question 12

Mx laryngeal SCC

Answer 12

Based on stage
Radiotherapy
Laryngectomy

Question 13

After total laryngectomy

Answer 13

Pts have permanent tracheostomy

• Speech valve
• Electolarynx
• Oseophageal speech (swallowed air)

Regular followup for recurrence