Polyps Flashcards
polyps
benign, soft, fluid filled epithelial lesions that appear on the vf margins secondary to laryngeal trauma
2 types of polyps
- sessile polyps
- pedunculated polyps
sessile polyps
- 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
pedunculated polyps
attached to the vf by a slim neck or stalk-like appendage
2 types of fluid within a polyp (one or the other, not both)
- seris
- hemorrhagic
seris fluid
thin and watery
hemorrhagic fluid
forms because of a hemorrhagic blood vessel, and is filled with blood
do not typically burst, but act as an…
inappropriately placed shock absorber
begin small, but as the phono-trauma continues…
they can grow larger
are polyps unilateral or bilateral?
unilateral, but can still damage the contralateral fold
can have ___glottic or ___glottic polyps
super, sub
most subglottic polyps are which type?
pedunculated polyps
the surgery is called…
microflat procedure
microflat procedure
- 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
___ can come from repeated phono-trauma or from a single instance of phono-trauma, while ___ always come from repeated phono-trauma
polyps, nodules
___ tend to be bilateral, while ___ tend to be unilateral
nodules, polyps
___ undergo a tissue change and become fibrotic, while ___ will always remain fluid filled
nodules, polyps
___ arise from the mucous membrane, while ___ are basement membrane zone tenants
polyps, nodules
___ tend to be larger and modre edemitus and vascular than ___
polyps, nodules
etiology of polyps
- 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
perceptual signs of polyps
- 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
diplophonia
production of 2 audibly different pitches during phonation
how does diplophonia occur?
the vf with polyp will vibrate at a slower rate, and the vf without polyp will vibrate at a faster rate
vocal break
shift in pitch either upward or downward
vocal arrest
complete stoppage
management is consumer driven
- what do they use their voice for?
- how do they want it to come back?
medical management may be the frontline treatment
- most effective and removes the polyp
- sessile polyp large or pedunculated polyp
medical management: during removal
- 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
medical management: steriods
- low dose
- treat as an inflammatory disorder
management: voice therapy
- could follow medical management
- role in elimination of the lesion and/or prevent of recurrence
- months of voice therapy
voice therapy is the frontline treatment for…
small sessile polyps
the smaller the polyp…
the quicker it will go away
management: role of SLP
- 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
why might SLP implement a short period of vocal rest?
- immediately following the surgery
- initially if polyp is small enough
