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Laryngeal tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Philip Touska, Steve Connor, Robert Hermans
Minor salivary glands are found throughout the mucosa of the oral cavity and upper respiratory tract. In the larynx, these glands are located in the supra- and subglottic regions; the glottis is devoid of minor salivary glands. Adenoid cystic carcinoma is most common, but adenocarcinoma and mucoepidermoid carcinoma may also occur. In the larynx, these tumours usually present as a submucosal mass in the subglottis (Figure 3.38). As they grow submucosally, they are often more extensive than clinically suspected.
Respiratory system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The glottis is the space containing the true vocal cords, the supraglottis contains the false cords and other structures including the epiglottis and the subglottis is the area of trachea immediately below the true cords. Small laryngeal tumours may not be visible on CT (hence the need for clinical assessment), but when a tumour is seen its size can be determined, likely site of origin confirmed and local invasion into adjacent spaces assessed. CT can also investigate extralaryngeal extension (though invasion of the thyroid cartilage is difficult to assess accurately) and cervical lymph node metastasis can be demonstrated.
Chronic Laryngitis
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Invariably, tuberculosis (TB) occurs with the pulmonary version of the disease, with the patient complaining of dysphonia, pain on speaking and swallowing, and otalgia. There is a diffusely reddened and oedematous larynx affecting predominantly the posterior one third of the glottis. There may be ulceration and the appearances can be confused with squamous cell carcinoma. Thus, it is imperative to obtain histological confirmation before embarking on radical treatment. Diagnosis is made by biopsy of the laryngeal tissues. Histological examination demonstrates granulomas with caseating necrotic centres, Langhans-type giant cells and mycobacterium organisms. Treatment is to secure an airway followed by anti-tuberculous drugs. If timely there should be resolution of the laryngeal and pulmonary disease and if not there will be the effects of chronic inflammation with stenosis and vocal cord fixation.57, 58
Mobility of the arytenoid cartilage in glottic carcinoma: a CT image study
Published in Acta Oto-Laryngologica, 2023
Li Wang, Xi Zeng, Kai Li, Yunxin Lu, Dongxiao Nong
Fibreoptic laryngoscopy provides excellent views of mucosal waves, mucosal lesions, and VC/AC mobilities. It offers undoubtful advantages for clinical evaluation and staging of laryngeal carcinoma and helps to develop a tailored therapeutic plan. Nevertheless, laryngoscope enables only subjective assessment. The 3D structure of the laryngeal cartilage is complex, many structures are deeply embedded in soft tissues and are not visible or measurable through a laryngoscope, making qualitative descriptions and quantitative measurements impossible. Difficulties in assessment also arise when a large laryngeal tumour partially or even completely obscured the glottis. Compared to laryngoscopy, CT scan is weak in early mucosal changes and continuous images, yet has an outstanding performance in presenting various laryngeal structures including cartilages and cords.
Life-threatening idiopathic subglottic stenosis misdiagnosed as asthma
Published in Acta Oto-Laryngologica Case Reports, 2022
Niloofar Sherazi Dreyer, Kristine Grubbe Gregersen, Kristian Hveysel Bork
Subglottic stenosis is the obstruction of the central airway in the region below the glottis and bounded inferiorly by second tracheal ring. Causes of subglottic stenosis can be congenital, acquired, or idiopathic. The most common causes are trauma following intubation (prolonged/repetitive intubation or excessive endotracheal tube cuff pressure) and tracheostomy. Acquired causes may be external and internal traumas. External are typically trauma to the neck/larynx and internal traumas can include (intubation or tracheotomy) as mentioned earlier. Other acquired causes include infections as bacterial tracheitis, tuberculosis, gastroesophageal reflux disorder (GERD), systemic diseases (amyloidosis, sarcoidosis, polyarteritis, granulomatosis with polypangiitis), radiation therapy, inhalational injury, tracheal malignancy, and foreign body aspiration [1].
Video laryngeal masks in airway management
Published in Expert Review of Medical Devices, 2022
Manuel Á. Gómez-Ríos, Teresa López, José Alfonso Sastre, Tomasz Gaszyński, André A. J. Van Zundert
Potential complicates are due to a (forceful) insertion of SADs causing trauma and injury to: a) teeth, lips, tongue; b) mucosa of the oropharynx (blood staining, bleeding); c) glottic structures (vocal cords, epiglottis, arytenoids); d) nerves (recurrent laryngeal, lingual, hypoglossal, inferior alveolar nerves); e) lungs (pulmonary edema may follow vigorous biting on the shaft of the SAD resulting in complete obstruction of the airway); f) laryngospasm and bronchospasm; and g) temporomandibular joint dysfunction [1,30,31]. Sore throat, dysphonia, and dysphagia may result after incorrect insertion of the device or inadequate monitoring of intracuff pressure, avoiding hyperinflation, which results in a decrease in mucosal perfusion. Meticulous attention to the correct insertion process and continuous evaluation of intracuff pressure (during induction and maintenance of anesthesia) is warranted to avoid these traumata.