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ENT > Laryngeal Pathology > Flashcards

Laryngeal Pathology Flashcards

1
Q

what is globus pharyngeal?

A

sensation of lump in the throat

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2
Q

what are the causes of globus pharyngeal?

A

unclear, possibly excess muscle tension in the pharynx, or increased acid exposure at laryn-oesopharyngeal junction

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3
Q

what are the clinical features of globus pharyngeal?

A

sensation of a lump in the throat that is most noticed when swallowing salvia
mucus unable to clear
No primary swallowing difficulty
Symptom come and go (worse when stressed or tired)

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4
Q

how is globus pharyngeal managed?

A

reassure, endoscope to exclude malignancy

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5
Q

what is the cause of vocal nodules?

A

vocal abuse. Infection, smoking, occ hypothyroidism

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6
Q

what is the pathophysiology of vocal nodules?

A

o Reactive change in laryngeal muscosa

o Localised, benign, superficial growths on medial surface of true vocal cords

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7
Q

what are the features of vocal nodules?

A

young women, blilateral on middle 1/3 to posterior 1/3

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8
Q

what are the features of laryngeal polyps?

A

unilateral + pedunculated

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9
Q

what are the clinical features of vocal nodules?

A

hoarseness, change in voice quality, increased effort to produce voice

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10
Q

how are vocal nodules diagnosed?

A

micro laryngoscopy and bronchoscopy

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11
Q

how are vocal nodules managed?

A

o Non medical – speech therapy, humidification, voice training, allergies
o Surgical – MLB procedure

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12
Q

what are the causes of contact ulcers of the larynx?

A

Chronic throat infection
Voice abuse
GI reflux
Intubation

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13
Q

what are the clinical features of contact ulcers?

A
  • Hoarseness
  • Low pitch/voice quality
  • Throat clearing
  • Cough
  • Pain
  • Rough sensation
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14
Q

how are contact ulcers diagnosed?

A

nasopharyngoscopy, pH paper

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15
Q

what is the management of contact ulcer?

A
  • Speech therapy, vocal rest, anti-reflux medication
  • Steroids
  • Botox
  • Lose dose radiology
  • Laser surgery
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16
Q

where are contact ulcers found?

A

Found on medial or superior edge of the vocal process of arytenoid cartilage

17
Q

what is the pathophysiology of contact ulcers?

A
  • Benign response to injury
  • Occur when mucosa is broken down
  • Ulcer forms accompanied by granulation tissue formation
18
Q

what are the macroscopic features of contact ulcers?

A
  • Pale, pedunculated masses

* Can also be deep red, lobulated and sessile

19
Q

what is laryngomalacia?

A

excessive collapse and indrawing on the supraglottic airway during inspiration

20
Q

what are the clinical features of laryngomalacia?

A

stridor, feeding and breathing difficulties

21
Q

what is the cause of laryngomalacia?

A

congenital anomaly of laryngx

22
Q

what is the management of laryngomalacia?

A

non required, surgery in severe cases

23
Q

what are the causes of snoring?

A

genetic predisposition, lifestyle factors – obesity, smoking, alcohol, throat weakness , mispositioned haw, obstruction in nasal passageway, obstructive sleep apnoea, sleep deprivation, sleeping on back, mouth breathing

24
Q

what is the mechanism of snoring?

A

the result of the relaxation of the uvula and soft palate. These tissues can relax enough to partially block the airway, resulting in irregular airflow and vibrations

25
Q

what is obstructive sleep apnoea?

A

the result of the relaxation of the uvula and soft palate. These tissues can relax enough to partially block the airway, resulting in irregular airflow and vibrations

26
Q

what are the causes of obstructive sleep apnoea?

A

obesity, fat deposition around neck, male, smoking, alcohol, sedative drugs, FH, nasal obstruction, kids = large adenoids/tonsils

27
Q

what are the clinical features of obstructive sleep apnoea?

A

excessive daytime sleepiness
Sleep symptoms – snoring, thrashing, feeling of choking
Partner gives details of apnoeic episodes – true apnoea >10 seconds
Poor sleep quality
Morning headache
Decreased libido
Cognitive performances – difficulty concentrating Irritability/personality change

28
Q

what is the gold standard set of investigations for sleep apnoea?

A

polysomnography – EEG, electrooculogram, electromyogram

29
Q

what is the diagnostic criteria for OSA?

A

five apnoea’s per hour recorded on a sleep study, plus symptoms of OSA

30
Q

what are the scales used for OSA?

A

o Epworth Sleepiness Scale

o Apnoea-hypopnoea Index

31
Q

what is the criteria of mild OSA?

A

1-14 apnoea per hour

32
Q

what is the criteria of moderate OSA?

A

15-30 apnoea’s per hour

33
Q

what is the criteria of severe OSA?

A

> 30 apnoea per hour

34
Q

what is the management of OSA?

A

o Non Interventional - weight loss, Avoidance if tobacco and alcohol, Sleep advice
o CPAP via nasal mask – moderate to severe disease
o Surgery – to relieve pharyngeal obstruction (tonsillectomy, uvulopalatopharyngoplasty or tracheostomy

ENT (13 decks)

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