Structural Anomalies of the Larynx

Question 1

Three Major Groups of Symptoms

Answer 1

1) Respiratory difficulties due to airway obstruction
2) Hoarseness or a weak or aphonic cry
3) Dysphagia

Question 2

Congenital Subglottic Hemangiomas

Answer 2

Large dark reddish colored masses often found in the subglottic region
Rare
Typically found in children, but may occur in adults
Symptoms may appear 2-3 months after birth, most growth noted between 6-12 months then spontaneously regress in size

Question 3

Congenital Subglottic Hemangiomas Characteristics

Answer 3

May be asymptomatic, or stridor, hoarseness, excessive coughing

Question 4

Congenital laryngeal webs/laryngeal atresia

Answer 4

Connective tissue in subglottic, glottic, and supraglottic regions
Laryngeal atresia: Tissue that completely occludes the larynx at birth
Etiology: failure of the vocal fold tissue to separate during the first trimester of pregnancy

Question 5

Congenital laryngeal webs/laryngeal atresia characteristics

Answer 5

Asymptomatic is web is not located at level of glottis
Vary depending on location and extent of lesion- may affect phonation and respiration
If vibratory behavior is affected, will affect habitual frequency

Question 6

Laryngeal Cleft

Answer 6

Vertical opening between the larynx (cricoid cartilage) and the esophagus
Etiology: results from a failure of the dorsal fusion of the cricoid lamina

Question 7

Laryngeal Cleft Characteristics

Answer 7

Symptoms usually occur shortly after birth; associated with other congenital anomalies
Respiration obstruction
Weak cry/aphonia
Repeated pneumonia

Question 8

Laryngocele

Answer 8

Air or fluid filled dilation or herniation of the saccule extending upward within the false vocal fold
Three types: internal laryngocele, external laryngeocele, combination laryngocele
Etiology: may occur in infants/children
May be acquired: excessive pressure within larynx (instrument, weight lifting, excessive coughing, etc.)

Question 9

Laryngocele Characteristics

Answer 9

Often asymptomatic in infancy
Hoarse voice or cry
Inspiratory stridor (if internal)
External bulge in neck

Question 10

Papilloma

Answer 10

Benign tumor that starts in the epithelium; may occur in various parts of the larynx
Etiology: Virus (HPV)

Question 11

Papilloma Characteristics

Answer 11

Hoarseness
May also include low pitch, breathiness, and strained vocal quality in the adult patient
Children may present with a weak cry, chronic cough, swallowing difficulties, and stridor

Question 12

Laryngomalacia

Answer 12

Excessive flaccidity of the supraglottic larynx
Inspiratory stridor
Often spontaneous recovery in 12-18 months
Etiology: Congenital; delayed or insufficient calcium deposition in infants resulting in inadequate support for the cartilaginous epiglottis; causing the epiglottis to collapse/fold over the glottis during inspiration

Question 13

Laryngomalacia Characteristics

Answer 13

Inspiratory stridor, dyspnea; cyanosis, normal cry

Question 14

Cri-du-chat Syndrome

Answer 14

Excessive flaccidity of the supraglottic larynx
Identical appearance of laryngomalacia
Etiology: partial deletion of chromosome 5
Other symptoms include: mental/physical retardation, beak like profile, microcephaly, hypotonia, etc.

Question 15

Cri-du-chat Syndrome Characteristics

Answer 15

Presence of a weak, wailing cry

Question 16

Congenital Subglottic Stenosis

Answer 16

Narrowing of the airway between the glottis and the first tracheal ring
Acquired stenosis is often the result of prolonged intubation
Etiology: thickening of subglottic tissue and/or vocal folds
Cartilaginous narrowing of the cricoid cartilage- small posterior opening

Question 17

Congenital Subglottic Stenosis Characteristics

Answer 17

Stridor on inhalation and exhalation, less severe cases may be perceived as croup, reduced intensity of airway