OtoLogic

Question 1

The technical components that optimize laryngoscopy include_____, complete muscle relaxation, firm forward and upward traction on the laryngoscope, and, if necessary, firm external laryngeal manipulation with cricoid pressure.

Answer 1

The technical components that optimize laryngoscopy include Proper Head Position, complete muscle relaxation, firm forward and upward traction on the laryngoscope, and, if necessary, firm external laryngeal manipulation with cricoid pressure.

Question 2

The technical components that optimize laryngoscopy include proper head position, ____, firm forward and upward traction on the laryngoscope, and, if necessary, firm external laryngeal manipulation with cricoid pressure.

Answer 2

The technical components that optimize laryngoscopy include proper head position, Complete Muscle Relaxation, firm forward and upward traction on the laryngoscope, and, if necessary, firm external laryngeal manipulation with cricoid pressure.

Question 3

56F presenting w/stridor. She also has a history of RA and Hashimoto’s thyroiditis. On DL, you notice subglottic stenoiss. She is scheduled for Surgery, and you discuss bx. What is the dx?

Answer 3

Granulomatosis w/polyangitis (GPA) or Wegener granulomatosis (WG)

Question 4

56F presenting w/stridor. She also has a history of RA and Hashimoto’s thyroiditis. On DL, you notice subglottic stenoiss. She is scheduled for Surgery, and you discuss bx. What is the bx likely to show?

Answer 4

Necrotizing Granulomatosis and necrotizing vasculitis of smwall arteries/arterioles, capillaries and venules

Question 5

cough, increased mucus production, oral mucosa ulcers and fatigue after visitng Mississippi River valley.

Answer 5

Histoplasmosis

Question 6

Laryngoscopic characteristics of the aging larynx include ___, a yellowish or dark grayish discoloration of the vocal fold, and vocal fold atrophy

Answer 6

Laryngoscopic characteristics of the aging larynx include edema, a yellowish or dark grayish discoloration of the vocal fold, and vocal fold atrophy

Question 7

Laryngoscopic characteristics of the aging larynx include edema, ____ discoloration of the vocal fold, and vocal fold atrophy

Answer 7

Laryngoscopic characteristics of the aging** larynx include edema, a yellowish or dark grayish discoloration of the vocal fold, and vocal fold atrophy

Question 8

Laryngoscopic characteristics of the aging larynx include edema, a yellowish or dark grayish discoloration of the vocal fold, and _____.

Answer 8

Laryngoscopic characteristics of the aging larynx include edema, a yellowish or dark grayish discoloration of the vocal fold, and vocal fold atrophy

Question 8

Reinke’s space

Answer 8

Superficial lamina propria

Question 8

Muscle of the vocal fold

Answer 8

Vocalis muscle

Question 9

Layers of the vocal ligament

Answer 9

1) Intermediate lamina propria
2) Deep lamina propria

Question 9

When the vocal process of the paralyzed vocal fold lies near the midline, ___ is the preferred treatment mechanism.

Answer 9

**Injection laryngoplasty or medialization laryngoplasty **

Question 10

Which layer of the vocal fold is immediately visible during DL: BM or Squamous epithelium?

Answer 10

Squamous epithelium

Question 11

When the vocal process is significantly laterally displaced (aka flaccid laryngeal paralysis), thyroplasty or injection laryngoplasty is inadequate to achieve glottic closure.

Answer 11

Arytenoid adduction plus thyroplasty are superior to the results of thyroplasty alone

Question 12

____ measure, quantifies a patient’s perception of his or her voice and its chang in response to therapy.

Answer 12

Voice Handicap Index

Question 13

What is the most commonly used adjuvant therapy for Recurrent Respiratory Papillomatosis?

Answer 13

Cidofovir (broad spectrum antiviral agent)

Question 14

A trach patient presenting to clinic w/hopes of getting rid of the tracheostomy. You perform DL and witness the (image) on maximal abduction. Whtat procedure has the potential to preserve phonatory adduction while decannulating this patient?

Answer 14

Arytenoid ABduction

Question 15

Narrow band imaging of a VF lesion w/2 vascular loops branching from the lesion, is consistent with ___ risk for malignancy.

Answer 15

High risk for malignancy

Question 16

Data suggects serial intra-lesional steroid injections (SILSI) are effective, but there is a risk of ___ side effect.

Answer 16

in the Neevel et al. study, 32% of patient had glucocorticoid side effects including Cushing’s syndrome, increased intra-ocular pressure, central serous choreoretinopathy and new insulin requirement in the setting of diabetes

Question 18

Data suggests that topical application of mitomycin C (MMC) is __(effective/not effective) in reducing the number of procedures or improving outcomes.

Answer 18

not effective

Question 19

Patients w/GPA-assoc SGS W/glottic involvement has a ___ likelihood of re-stenosis.

Answer 19

Higher likelihood of re-stenosis

Question 21

Patients who undergo laser wedge excisions (LWE) for SGS as their primary procedure have a ___ time to recurrence than patients who underwent LWE as a secondary procedure

Answer 21

Longer time to recurrence (4.6yrs as opposed to 2.9yrs)

Question 22

Patients treated w/_____ following LWE for SGS are less at risk of recurrence.

Answer 22

triple therapy (Steroids + reflux meds + Bactrim)

Question 23

Most effective Tx for cricopharyngeal dysfunction?

Answer 23

Cricopharyngeal myotomy via open approach

Question 24

Rigid endoscopic ZD repair has a ___ rate of recurrence than flexible endoscopic ZD repair

Answer 24

lower rate

Question 25

What is the healing time for trans-oral laser resection of T1 SCCa of the TVF?

Answer 25

3 months to 6 months

Question 26

A 76-year-old patient with significant smoking history and COPD treated with Inhaled corticosteroids (ICS) and long-acting bronchodilators (LABA) presents for increasing hoarseness. you note a white plaque on the right true vocal fold. you recommend:

Answer 26

**Oral fluconazole w/close f/u **is favored as first steps in mgmt over bx

Question 27

More ___ locations of RLN injury have longer times to recovery

Answer 27

distal

Question 28

RLN injury at the level of the thyroid has a ___ recovery time than at the level of the heart/lung

Answer 28

shorter

Question 29

Which of the following are RFs for post-extubation dysphagia?
1. duration of intubation
2. Male gender
3. timing of swallowing assessment
4. swallowing assessment method

Answer 29

None. There are no meaningful RFs for post-extubation dysphagia.