Laryngology

Question 1

TVF layers

Answer 1

1 - Stratified squamous epithelium
2 - Superficial layer of lamina propria (corresponds to Reinke’s space)
3 - Vocal ligament
-- Intermediate layer of lamina propria
-- Deep layer of lamina propria
4 - Vocalis muscle

Question 2

MC site of amyloidosis in airway

Answer 2

larynx

Question 3

Yellow lesion on posterior one-third of vocal fold with pseudoepitheliomatous hyperplasia

Answer 3

Granular cell tumor

Question 4

Two occult sites for RRP

Answer 4

Nasopharynx

Undersurface of TVF

Question 5

MC site of sarcoid

Answer 5

Epiglottis

- appears pale pink, turban-like

Question 6

RLN paralysis, VF position

Answer 6

Paramedian

Question 7

Vagal paralysis, VF position

Answer 7

Lateral/intermediate

- hypernasal speech

Question 8

Airway lengthening techniques

Answer 8

1 - Mobilization after blunt dissection of the larynx and trachea (3 cm

2 - Incision of the annular ligaments on one side of the trachea proximal to the anastomosis and on the opposite side distally (1.5 cm)

3 - Laryngeal release

• • Suprahyoid (5cm)
• • Infrahyoid (often results in dysphagia)

Question 9

Gutman sign

Answer 9

SLN paralysis

In the normal individual, lateral pressure over the thyroid cartilage causes an increased voice pitch, whereas anterior pressure causes a decrease

In SLN paralysis, the reverse is true

Question 10

Venturi jet ventilation, complications

Answer 10

hypoventilation
pneumothorax
pneumomediastinum
subcutaneous  emphysema
abdominal  distention
mucosal dehydration
distal seeding of malignant cells or papilloma-virus particles

Question 11

How to test voice in Myasthenia Gravis

Answer 11

Edrophonium (Tensilon test) improves voice fatigue