Chapter 20: Benign Laryngeal Disorders Flashcards Preview

Boies > Chapter 20: Benign Laryngeal Disorders > Flashcards

Flashcards in Chapter 20: Benign Laryngeal Disorders Deck (106)
Loading flashcards...
1

Normal infant larynx

1. Situated higher in the neck than that of the adult
2. Softer, less rigid and more compressible by airway pressures
3. At the level C2-C4. (Adult: C4-C6)
4. 7 mm in the anteroposterior length and opens approximately 4mm in a lateral direction

2

1. Exaggeration of the soft, flabby state that is normal for newborns
2. As the infant inhales, the soft larynx falls together, narrowing the inlet and stridor results
3. Swallowing is unaffected

Laryngomalacia

3

Direct examination of laryngmalacia

1. Larynx fall together with inhalation
2. Subglottic area is normal
3. Stridor ceases if the larynx is held open with laryngoscope

4

Most infants cease to have the stridor by the 12th to 15th month

Laryngomalacia

5

Can be associated with a 2nd upper airway abnormality

Laryngomalacia

6

Disorder of the trachea due to lack of rigidity of the tracheal cartilages

Tracheomalacia

7

1. Subglottic diameter less than 4 mm
2. Presents with stridor shortly after birth or recurrent episodes of laryngotracheitis
3. Mild cases: observation, most cases require tracheotomy
4. Growth tends to resolve the relative stenosis, but laser excision or reconstructive surgery may be necessary

Congenital subglottic stenosis

8

Congenital webs

1. Glottic (75%)
2. Subglottic (12%)/Supraglottic (12%)

9

Both the airway and the cry or voice are affected, with the symptoms beginning at birth

Congenital webs

10

Congenital webs treatment

1. Laser or surgical excision
2. Repeated dilatation
3. Tracheotomy

11

1. May have airway obstruction or simply do not grow
2. Voice and swallowing and normal
3. Arise from the base of the tongue, aryepiglottic folds or false cords
4. If its possible: excision
5. Not possible: aspiration or marsupialization

Congenital cysts

12

1. Occurs primarily in infants under 6 months of age
2. Presence of external hemagioma plus stridor
3. Tends to regress, usually by the age of 12 months
4. Lateral xray: mass in the airway
5. Endoscopic: smooth, compressible mass often on the posterior or lateral wall
6. Tx: tracheotomy and allowing time for regression, laser excision

Hemagioma

13

1. Special type of congenital cyst that develops as s residual from a small appendix or saccus of the laryngeal ventricle
2. Present at any age but its origin is congenital

Laryngocele

14

1. As the cyst begins, it first causes a bulging of the false vocal cord on that side
2. With enlargement, the cyst dissects along the superior laryngeal nerve and vessels to present as mass in the neck
3. As they enlarge, they encroach on the airway and may cause stridor and airway obstruction

Laryngocele

15

Treatment for laryngocele

Dissection of the cyst using an external approach accompanied by a temporary tracheostomy

16

Result of a failure of fusion of the dorsal portions of the cricoid cartilages

Laryngotracheoesophageal cleft

17

There is an associated failure of closure of the tracheoesophaheal septum, thus creating a groove in the region of the cricoid cartilage

Laryngotracheoesophageal cleft

18

1. Infant may have cyanosis, respiratory distress and recurrent episodes of pneumonia
2. Associated changes in the cry as well as inspiratory stridor
3. Direct laryngoscopy: normal larynx

Laryngotracheoesophageal cleft

19

Causes of vocal cord paralysis in infants

1. Birth canal trauma
2. Meningocele or mediatinal mass
3. Increase ICP

20

Unilateral vocal cord paralysis is more common on the...

Cleft

21

Children with bilateral vocal cord paralysis can have a...

Normal cry

22

Recovery of vocal cord paralysis

6-9 months but may take up to 14 months

23

1. Manifested by internal hematomas and occasionally by dislocation of the arytenoid cartilage
2. Caused by some blunt object striking an extended neck
3. Direct laryngoscopy: reduces the dislocated arytenoid cartilage

Mild contusions of the larynx

24

Don not cause airway obstruction, since the pharynx is very wide at this level

Hyoid fractures

25

The greater cornu of the hyoid does not normally unite to the body until...

Age 35

26

Treatment of hyoid bone fractures

Expectant

27

Signs of laryngeal fracture

1. Hoarseness
2. Inspiratory or expiratory stridor
3. Hemoptysis
4. Subcutaneous emphysema

28

When laryngotracheal separation occurs, the trachea will retract into the lower neck

Emergency tracheostomy is required

29

Most likely fracture runs in a...

Vertical plane from the bottom of the thyroid notch to the lower border of the cartilage

30

Avulsion of the thyroid cartilage from the cricoid and trachea...

1. Facial pain
2. Aphonia
3. Subcutaneous emphysema