AhmedYassinBahgat;MD,MSc,EBE-ORLLecturerofORLdepartment,AlexandriaUniversity

FellowofEuropeanboardofOtolaryngology-Head&necksurgeryClinicalandresearchFellowofUniversityofPavia(Italy),UniversityofVersailles(France),UniversityofCentralFloridaUCF&Universityof

SouthernCaliforniaUSC(USA).InternaLonalSDBSBoardcerLfied.MemberofAAO-HNS,ISSS,ERS

Hoarsenessofvoice

Normal voice

Hoarsenessofvoice

• Functional: hysterical

• Organic:

• Congenital: VC web, paralysis

• Inflammatory: laryngitis, MAP lesions, Laryngocele

• Traumatic: laryngeal trauma

• Neurological: VC paralysis

• Neoplastic: Benign & malignant laryngeal tumors

• Aging: Presbylarynx

Nodules,polyps

Vocal Nodules

Vocal Polyp

Contact granulomas

Contact granulomas

Reinke’s edema

•Heavy smoking •Hoarseness of voice •Polypoidal degeneration •Treatment: • Elimination of irritating

factors, especially anti-reflux treatment.

• Voice rest. • MLS.

Reinke’s edema

Vocal cord cyst

Leukoplakia

Microlaryngosurgery

MLS (VC polyp)

Laryngocele

Laryngocele

Laryngocele(pathogenesis)

Neonatal(Congenital)Adult(Primary&Secondary)

Congenital weakness Persistent large saccule

Occupational

CancerlarynxBenigntumorsGranulomas

ProlongedintubaEon

Symptoms •Dysphonia (hyper-resonance). •Dyspnea & stridor •Cough. •Neck swelling. •Dysphagia or feeding difficulty.

Signs• Compressible neck swelling. • Bryce’s sign (gurgling or hissing

on compression). • Ballooned FVC, AEF, or

vallecula.

Laryngocele(Clinicalpicture)

UnilateralVCparalysis

• Mostcommoncause:Iatrogenicfollowingthyroidectomyoperation• Treatment:Vocalfoldinjection(medializationthyroplasty)

RecurrentRespiratoryPapillomatosis

RecurrentRespiratoryPapillomatosis

Juvenile Adult

Number Multiple Solitary

Recurrence Common Uncommon

Malignant transformation Rare Common

RecurrentRespiratoryPapillomatosis

Subglottic Haemangioma

Malignant laryngeal tumors

• Mechanical:weightofthetumorpreventingcordmovement

• Infiltrative:ofthyroarytenoidmuscleorcricoarytenoidjoint

• Paralytic:infiltrationofthenervefiberstothemuscles(verylate)

Hoarsenessofvoice

• Functional: hysterical

• Organic:

• Congenital: VC web, paralysis

• Inflammatory: laryngitis, MAP lesions, Laryngocele

• Traumatic: laryngeal trauma

• Neurological: VC paralysis

• Neoplastic: Benign & malignant laryngeal tumors

• Aging: Presbylarynx

-The diagnosis is A- subglottic haemagioma.

B- juvenile papillomatosis. C- laryngomalcia. D- glottic web.

LARYNX

- The causative organism is A-Herpes simplex virus B-Herpes Zoster virus C-Human papilloma virus D- Adenovirus

LARYNX

•  28 year old lady •  Caesarean section 2

months ago •  Hoarseness of voice

LARYNX

The diagnosis is A- Right vocal polyp B- Left intubation

granuloma C- Left Vocal polyp D- Right intubation

granuloma

LARYNX

The condition can be treated by A- LASER excision B- Laryngofissure and

excision C- cordectomy D- radiotherapy

LARYNX

The diagnosis is A- leukoplakia. B- Intubation granuloma. C- Vocal cord polyp. D- Adult papilloma.

LARYNX

The presentation of this condition is A- Referred Otalgia B- Stridor C- Change of voice D- All of the above

LARYNX

The treatment of this case is A- Antibiotics B- Microlaryngosurgery C- Cordectomy D- Radiotherapy

LARYNX

•  Recurrent respiratory papillomatosis in a child is characterized by all of the following except:

A. Frequently recurrent B. Affecting multiple sites C. More potentially malignant than that

ocurring in adults D. Best treated by repeated laser excision

•  Potentially malignant laryngeal lesions are all of the following except:

A. Leucoplakia B. Adult papilloma C. Reinke�s edema D. Plummer-vinson�s syndrome

•  Biphasic stridor may be due to:

A. Bronchial asthma B. Subglottic tumor C. Vocal cord paralysis D. Glottic carcinoma