The larynx
Rogan J Corbridge in Essential ENT, 2011
The main function of the larynx is to act as a sphincter to protect the lower airways from contamination by foods, liquids and secretions. It also allows the production of an effective cough, which is essential in clearing unwanted matter from the airway. In humans, the larynx has evolved as a highly complex organ for the production of sound vibrations. The larynx is essentially a tube made up of a series of cartilages and bone, which are held together by interconnecting membranes, ligaments and muscles. Any disease process affecting the larynx may interfere with the function of this organ. Thus, diseases of the larynx present with either voice or airway problems, or not infrequently a combination of both. The vocal cords appear reddened and oedematous; often the whole larynx is generally inflamed, with swelling of the arytenoids and false cords, and the epiglottis may appear red at its tip.
Feminisation of the larynx and voice
James Barrett in Transsexual and Other Disorders of Gender Identity, 2017
The larynx is a complex structure, and its principal function is to protect the airway during swallowing. In humans the larynx is uniquely designed to play a pivotal role in communication through speech. The skeleton of the larynx consists of a series of single and paired cartilages united by ligaments and membranes. The nerve supply to the larynx is from branches of the vagus nerve. In the larynx the vibration passes as a passive mucosal wave in the vocal folds from below upwards. The tension in the vocal cords can be increased by exposing the larynx and advancing the anterior commisure, which is then held forward by a mini-plate. The effects of androgens are irreversible and lead to vocal cord lengthening, increased muscle bulk and the production of more viscous mucous. This leads to 'breaking' of the voice and lowered vocal pitch. The requirements for voice include an air source, vibrating organ, articulators and resonators.
The respiratory system
Peter Kopelman, Dame Jane Dacre in Handbook of Clinical Skills, 2019
Respiratory diseases often lead to hospital admission, and patients with chronic obstructive pulmonary disease may require repeated admissions for infective exacerbations. Smoking remains the single most important cause of respiratory disease despite greater awareness of the dangers of cigarette smoking and health warnings placed in advertisements and on cigarette packets. The nasal cavities form the first part of the respiratory passage and extend from the anterior nares or nostrils to the nasopharynx. The nares are lined with respiratory epithelium, with some olfactory epithelium. The respiratory tract includes the nose, nasopharynx and larynx, extending down into the alveoli to include the blood supply. A history of childhood asthma, pneumonia or whooping cough is sometimes relevant to the later development of chest symptoms in an adult. Chest injuries and previous pneumonia may explain changes seen on a chest X-ray.
Numerical analysis and comparison of flow fields in normal larynx and larynx with unilateral vocal fold paralysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Amirhossein Bagheri Sarvestani, Ebrahim Goshtasbi Rad, Kamyar Iravani
In this study, laryngeal flow fields are investigated and compared in normal larynx and models of larynx with unilateral vocal fold paralysis (UVFP). In paralytic models, three fixed initial glottal gaps are considered to understand the positive or probable negative impacts of surgical operation on unilaterally paralytic larynx, by which the paralyzed vocal fold is brought closer to the mid-plane. Various features of the flow fields have been discussed in detail including glottal gap width, glottal flow rate, glottal exit pressure pattern and glottal jet evolution. The numerical solution of fluid-structure interaction is carried out using ANSYS, and the results confirm some of the favorable effects of surgery on the patient’s larynx. It is also shown that by tightening the glottal gap, some of the problems caused by the presence of a motionless vocal fold, such as leakage through glottal gap in the closure phase resulting in breathy voice can be moderated, although some of the symptoms of this disorder remain relatively unchanged.
Evaluation of gender-specific aspects in quality-of-life in patients with larynx carcinoma
Published in Acta Oto-Laryngologica, 2016
Sarah Tan, Thien An Duong Dinh, Martin Westhofen
Conclusions: The results suggest that gender-specific differences in health-related quality-of-life (HRQoL) exist in patients with larynx carcinoma. In previous studies these differences might have been concealed by predominantly male subject groups. Future studies should consider a gender-specific analysis that suits the patient’s idiosyncrasies associated with laryngeal cancer. Objectives: There is little research concerning gender differences in quality-of-life (QoL) in patients with larynx carcinoma. Since laryngeal cancer is predominantly found in males, most studies examining HRQoL are based on a mainly male subject group. HRQoL needs to be assessed to determine the impact of disease and treatment and to evaluate possible treatment regimes. This study examined gender differences concerning HRQoL in 53 patients using EORTC QLQ-C30, and QLQ-H&N35 questionnaires. Methods: Patients treated with larynx carcinoma were given two questionnaires to assess HRQoL. The questionnaires were analyzed for each sex separately, as well as for the entire population. Results: Female patients report significantly worse HRQoL than males. Age could not be identified as a significant predictor for HRQoL when males and females were analyzed together, and does not significantly predict HRQoL in men. However, age was found to be a significant predictor for HRQoL when only females were analyzed.
Nasal fiberoptic intubation with and without split nasopharyngeal airway: Time to view the larynx & intubate
Published in Egyptian Journal of Anaesthesia, 2018
Ahmed A. Mohamed El-Tawansy, Osama A. Nofal, Akmal Abd Elsamad, Hala A. El-Attar
BackgroundFiberoptic intubation requires long nasopharyngeal journey and mostly requiring jaw thrust to visualize larynx especially if done under general anesthesia. Use of split nasopharyngeal airway of appropriate length for better glottis visualization has been compared with the classic one. MethodsAdult 68 patients; ASA I and II; undergoing surgery under general anesthesia were allocated randomly and equally into CL group in which classic nasal FOI with jaw thrust was done and NP group in which appropriate length of SNPA was inserted nasally followed by insertion of the scope with the application of jaw thrust if needed. Preprocedural heart rate, blood pressure and saturation and every minute for 5 min and also procedure and endoscopy time required to visualize the larynx (T1 and T3 respectively), carina (T4) and to remove the scope (T5) were recorded. ResultsHeart rate showed a statistically significant increase in CL and NP group during study time compared to pre-procedure reading. The MAP showed also statistical increase but only in CL group. There was a statistical (not clinical) significant increase between the percent of HR and MAP change in the CL group compared to NP group. T1, T3, and T5 in NP group were significantly shorter than in CL group but not for T4. Seven cases after SNPA needed jaw thrust. ConclusionUse of SNPA is safe and effective in reducing time to visualize larynx and intubate trachea. Developing longer specific “Naso-laryngeal (not nasopharyngeal) FOB intubating aid” is assumed to be more appropriate.
Related Knowledge Centers
- Epithelium
- Hyoid Bone
- Vocal Cords
- Vocal Folds
- Respiratory System
- Goblet Cells
- Voice