Laryngology Flashcards
Cotton Myers Staging
Subglottic Stenosis
1: 0-50%
2: 51-70%
3: 71-99%
4: 100%
Describe features of Reinkes Space Edema
Reinke’s space
superficial layer of the lamina propria, loose connective tissue (susceptible to fluid accumulation)
Risks
GERD, smoking, hypothyroidism, vocal abuse, chronic throat clearing, chronic cough
- not associated with increased risk of laryngeal cancer
Diagnosis
indirect mirror exam, flexible nasopharyngoscopy, endoscopy, videostroboscopy
Treatment
- Evaluate and manage for hypothyroidism and GERD (antireflux medications)
- Voice rest, smoking cessation
- Consider microlaryngoscopy and excision with removal of gelatinous material in Reinke’s space
What is the only muscle that abducts the vocal folds?
Posterior Cricoarytenoid
Paralysis of the posterior cricoarytenoid muscles may lead to asphyxiation as they are the only laryngeal muscles to open the true vocal folds, allowing inspiration and expiration
Innervated by the recurrent laryngeal nerve
Where does the recurrent laryngeal nerve enter the larynx?
Behind the cricothyroid articulation and
inferior cornu of the thyroid cartilage.
What is the triticeous cartilage?
In the thyrohyoid ligament.
Often mistaken for a foreign body on lateral Cspine xray
What is Plica Ventricularis?
- Occurs when a great amount of muscle tension above the vocal folds is created in the laryngeal area causing an approximation of the false vocal folds.
- In the extreme case, the ventricular (false) folds may actually be the source of vibration for voice production instead of the true vocal folds.
- The voice quality of ventricular phonation is typically a moderate to severe dysphonia characterized by low pitch, roughness, and strain. When true vocal fold vibration is physically possible, the ventricular phonation can benefit from treatment including counseling and vocal reeducation through direct voice therapy.
