Polyps

Question 1

polyps

Answer 1

benign, soft, fluid filled epithelial lesions that appear on the vf margins secondary to laryngeal trauma

Question 2

2 types of polyps

Answer 2

1. sessile polyps
2. pedunculated polyps

Question 3

sessile polyps

Answer 3

• broad-based polyps that closely adhere to the vf mucosa and involve it to varying extends
• can get big and take up a lot of the vf, but not the entire vf

Question 4

pedunculated polyps

Answer 4

attached to the vf by a slim neck or stalk-like appendage

Question 5

2 types of fluid within a polyp (one or the other, not both)

Answer 5

1. seris
2. hemorrhagic

Question 6

seris fluid

Answer 6

thin and watery

Question 7

hemorrhagic fluid

Answer 7

forms because of a hemorrhagic blood vessel, and is filled with blood

Question 8

do not typically burst, but act as an…

Answer 8

inappropriately placed shock absorber

Question 9

begin small, but as the phono-trauma continues…

Answer 9

they can grow larger

Question 10

are polyps unilateral or bilateral?

Answer 10

unilateral, but can still damage the contralateral fold

Question 11

can have ___glottic or ___glottic polyps

Answer 11

super, sub

Question 12

most subglottic polyps are which type?

Answer 12

pedunculated polyps

Question 13

the surgery is called…

Answer 13

microflat procedure

Question 14

microflat procedure

Answer 14

• open layres of the vf to expose the polyp
• scoop out the polyp, and then lay the cover back over
• vf will heal on it’s own easily

Question 15

___ can come from repeated phono-trauma or from a single instance of phono-trauma, while ___ always come from repeated phono-trauma

Answer 15

polyps, nodules

Question 16

___ tend to be bilateral, while ___ tend to be unilateral

Answer 16

nodules, polyps

Question 17

___ undergo a tissue change and become fibrotic, while ___ will always remain fluid filled

Answer 17

nodules, polyps

Question 18

___ arise from the mucous membrane, while ___ are basement membrane zone tenants

Answer 18

polyps, nodules

Question 19

___ tend to be larger and modre edemitus and vascular than ___

Answer 19

polyps, nodules

Question 20

etiology of polyps

Answer 20

• repeated or single instance of phono-trauma
• associated with middle age
• any type of phono-trauma
• allergies
• thyroid imbalances
• upper respiratory tract infections
• smoking and alcohol

Question 21

perceptual signs of polyps

Answer 21

• unable to compensate for them
• breathy voice
• possibly lower pitch
• throat clear a lot
• diplophonia within their voice
• sudden voice breaks (vocal arrest)
• if big enough, some airway obstruction

Question 22

diplophonia

Answer 22

production of 2 audibly different pitches during phonation

Question 23

how does diplophonia occur?

Answer 23

the vf with polyp will vibrate at a slower rate, and the vf without polyp will vibrate at a faster rate

Question 24

vocal break

Answer 24

shift in pitch either upward or downward

Question 25

vocal arrest

Answer 25

complete stoppage

Question 26

management is consumer driven

Answer 26

• what do they use their voice for?
• how do they want it to come back?

Question 27

medical management may be the frontline treatment

Answer 27

• most effective and removes the polyp
• sessile polyp large or pedunculated polyp

Question 28

medical management: during removal

Answer 28

• while doing as little damage as possible to the vf itself
• always a risk of a scar, which those on the vfs will never go away

Question 29

medical management: steriods

Answer 29

• low dose
• treat as an inflammatory disorder

Question 30

management: voice therapy

Answer 30

• could follow medical management
• role in elimination of the lesion and/or prevent of recurrence
• months of voice therapy

Question 31

voice therapy is the frontline treatment for…

Answer 31

small sessile polyps

Question 32

the smaller the polyp…

Answer 32

the quicker it will go away

Question 33

management: role of SLP

Answer 33

• if patient developed hyperfuction due to polyp, addressed with direct intervention
• implement a program of vocal hygiene
• elimination of vocal abuse/misuse
• might need to consider a short period of vocal rest

Question 34

why might SLP implement a short period of vocal rest?

Answer 34

• immediately following the surgery
• initially if polyp is small enough