Contenu connexe Similaire à Laryngealdisorders (20) 4. Pretest T or FPretest T or F
1. Reurrent laryngeal nerve1. Reurrent laryngeal nerve pure motor fiberpure motor fiber
larynxlarynx
3. Acute laryngitis3. Acute laryngitis
4.4. epiglottitis laryngospasmepiglottitis laryngospasm
5. Thumb5. Thumb’’s signs sign croupcroup
6. Vocal nodule6. Vocal nodule unilateral massunilateral mass
7. Vocal granuloma7. Vocal granuloma intubationintubation
8. Laryngeal trauma8. Laryngeal trauma intubationintubation
9. Most common symptom9. Most common symptom ของของ true vocal carcinomatrue vocal carcinoma
neck node enlargementneck node enlargement
11. MusclesMuscles
IntrinsicIntrinsic – adductors ;– adductors ; thyroarytenoid (truethyroarytenoid (true
vocal cord:TVC),vocal cord:TVC),
cricoarytenoid,cricoarytenoid, interarytenoidinterarytenoid
- abductor ;- abductor ; post cricoarytenoidpost cricoarytenoid
ExtrinsicExtrinsic -- cricothyroidcricothyroid
18. 1. Inflammation - Acute & chronic laryngitis, croup,
epiglottitis, ulcer,
2. Tumor - benign, nodule, polyp, granuloma
- malignancy
3. Trauma - penetrating injury
- blunt injury
- iatrogenic
4. Congenital - cord paralysis, Laryngeal web,
subglottic stenosis
5. Miscellaneous - laryngopharyngeal reflux (LPR)
disease
Laryngeal disordersLaryngeal disorders
19. Common laryngeal disordersCommon laryngeal disorders
1. Acute laryngitis1. Acute laryngitis
2. Croup2. Croup
3. Epiglottitis3. Epiglottitis
4. Vocal nodule4. Vocal nodule
5. Vocal polyp5. Vocal polyp
6. Vocal granuloma6. Vocal granuloma
7. Laryngeal carcinoma7. Laryngeal carcinoma
8. Laryngeal trauma8. Laryngeal trauma
9. Laryngopharyngeal reflux (LPR)9. Laryngopharyngeal reflux (LPR)
20. Acute laryngitisAcute laryngitis
Pathogen - adenovirus, influenzaPathogen - adenovirus, influenza
Morexella catarrharisMorexella catarrharis
Hemophilus influenzaHemophilus influenza
Streptococcus pneumoniaeStreptococcus pneumoniae
Symptoms - hoarseness
cough, +/- fever, malaise
Sign - TVC swelling
23. CroupCroup (acute laryngotracheobronchitis)(acute laryngotracheobronchitis)
- Severe respiratory infection- Severe respiratory infection
-- 6 months-2 yrs.
Pathogen - parainfluenza*influenza, adenovirus
- follow by bacterial esp. H. influenza
Symptoms - early URI symptoms
- 2-3 days
- barking cough, stridor
- exhausted, lying down
27. EpiglottitisEpiglottitis
- infection of supraglottis >> epiglottis- infection of supraglottis >> epiglottis
-- 2-10 yr., adult
Pathogen - H. influenza type B
Symptoms - early URI symptoms
- children > change very fast 6-12 hr.
- high fever, pain in throat
- นั่ง โน้มตัวมาข้างหน้า*
30. Vocal cord noduleVocal cord nodule
- vocal abuse, over-used
- children, adult
- fibrous formation
Symptoms - hoarseness
Sign - nodule TVC> bilateral
> anterior 1/3
32. Vocal polypVocal polyp
- vocal abuse- vocal abuse
-- Reinke edema > capsule surrounding (polyp)
Symptoms - hoarseness > 2 wk
Sign - ant 1/3 TVC, unilateral
Treatment - surgery
- follow by speech therapy
34. Vocal granulomaVocal granuloma
inflammation > ulcer > granulomainflammation > ulcer > granuloma
etiology - intubation
- gastroesophageal reflux
- partial laryngectomy
Symptoms - hoarseness 2-3 wk after extubation
37. CarcinomaCarcinoma
Symptoms > 2-3 weeks
- glottis > hoarseness
- supraglottis > dysphagia
- subglottis > airway problems
others - referred otalgia, chronic cough,
hemoptysis, lymphadenopathy,
wt. loss
38. CarcinomaCarcinoma
DiagnosisDiagnosis - biopsy ; indirect or direct- biopsy ; indirect or direct
laryngoscopylaryngoscopy
- extension ; CT, MRI- extension ; CT, MRI
- metastasis ; CXR, LFT- metastasis ; CXR, LFT
TreatmentTreatment - depends on staging TNM- depends on staging TNM
- early > surgery or RT alone- early > surgery or RT alone
- stage 3, 4 > combined- stage 3, 4 > combined
surgery, RT, ChemoRxsurgery, RT, ChemoRx
39. Laryngeal traumaLaryngeal trauma
Most common -Car accidentMost common -Car accident
OthersOthers - athlete, penetrating, gun-short- athlete, penetrating, gun-short
woundwound
S&SS&S >> location, severity>> location, severity
- stridor, bleeding, emphysema,- stridor, bleeding, emphysema,
hemoptysis, dysphagia, crepitationhemoptysis, dysphagia, crepitation
- severe case > coma- severe case > coma
40. Laryngeal traumaLaryngeal trauma
ชนิด การรักษา
Minor
- มีhematoma,emphysema, - explore ,แผล removetureignbody
tearofcartilage - วางdrain
- reconstructionofframework
+ intubation
Major
- multiplecartilagefracture - needintubationortracheostomy
- laryngotrachealsubluxation - exploration&reconstruction
+intraluminalstent
42. Laryngopharyngeal reflux (LPR)Laryngopharyngeal reflux (LPR)
Stomach acid > reflux to esophagus + othersStomach acid > reflux to esophagus + others
= gastroesophageal reflux (GER)= gastroesophageal reflux (GER)
reflux up to larynx = LPRreflux up to larynx = LPR
EtiologyEtiology - relax sphincter, acid production- relax sphincter, acid production
food ;food ; chocolate, spicy, cola, alcohol,chocolate, spicy, cola, alcohol,
drugs ;drugs ; theophylintheophylin
llife-styleife-style ;; eat late at nighteat late at night
43. Laryngopharyngeal reflux (LPR)Laryngopharyngeal reflux (LPR)
SymptomsSymptoms - feel lump in the throat,- feel lump in the throat,
chronic cough,chronic cough,
regurgitation, heartburnregurgitation, heartburn
SignsSigns -- arytenoid edema, TVC swelingarytenoid edema, TVC sweling
granuloma, ulcergranuloma, ulcer
>>> carcinoma>>> carcinoma
44. Laryngopharyngeal reflux (LPR)Laryngopharyngeal reflux (LPR)
TreatmentTreatment - Lifestyle modification- Lifestyle modification
diet, stress, avoid eatingdiet, stress, avoid eating
before bedtimebefore bedtime
- medication- medication
protonpump inhibitor,protonpump inhibitor,
H2 antagonist, antacidH2 antagonist, antacid
+ prokinetic+ prokinetic
- surgery- surgery
