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  • Slide 1
  • For any suggestions please call 0122358933
  • Slide 2
  • Laryngeal examination indirect laryngoscopy Laryngeal Mirror Technique of Indirect Laryngoscopy -Warm the mirror to the body temperature to avoid fogging of the mirror by the respiratory water vapour - Hold the tongue by a piece of gauze by your left hand -Hold the mirror by your right hand and place against the base of the uvula - Ask the patient to say eeee to assess adduction - Ask the patient to take deep inspiration to assess abduction
  • Slide 3
  • During phonation During quiet inspiration Base of the tongue Epiglootis Pyriform fossa Vocal foldsAry-epiglottic fold Arytenoid
  • Slide 4
  • Laryngeal examination Flexible fiberoptic nasolaryngoscopy Flexible endoscopic Examination of -Nasal cavity -Hypopharynx -Larynx
  • Slide 5
  • Rigid endoscopic examination of the larynx and hypopharynx
  • Slide 6
  • Direct Laryngoscope Indications Contraindications Diagnostic -To examine the Larynx -To take biopsy Therapeutic -Excision of benign lesions -Excision of small malignant tumors -Teflon injection -Arytenoidectomy -Removal of FB Severe Kyphosis
  • Slide 7
  • Micro-laryngeal surgery The use of the operating Microscope in direct Laryngoscopy is called MICRO-LARYNGOSCOPY Advantage: Provides Magnification Provides good illumination
  • Slide 8
  • Micro-laryngeal surgery employing laser Microscope Laryngoscope
  • Slide 9
  • Abduction: The vocal cords are apart for breathing in. The rings of the trachea can be seen ( yellow arrow).
  • Slide 10
  • During Phonation the vocal cords are adducted.
  • Slide 11
  • Laryngeal Web Whitish band in the anterior part of the glottis Congenital laryngeal Web Presentation - Newly born with hoarse weak cry
  • Slide 12
  • laryngomalacia The supraglottis is collapsing inwards during inspiration Presentation: -Inspiratory stridors -Starts soon after birth -Improves in prone position -Normal cry
  • Slide 13
  • Subglottic Hemangioma May be accompanied with hemangiomas in other sites
  • Slide 14
  • Posterior laryngeal cleft
  • Slide 15
  • Intubation granuloma Causes Prolonged intubation Blind intubation
  • Slide 16
  • Reinkes edema Voice abuse
  • Slide 17
  • Vocal nodules
  • Slide 18
  • Vocal polyp
  • Slide 19
  • Multiple Papillomatosis
  • Slide 20
  • Epiglottitis
  • Slide 21
  • Croup
  • Slide 22
  • Laryngoscleroma (subglottic web) Vocal cord Greenish crusts Vocal cord Rhinoscleroma Subglottic stenosis
  • Slide 23
  • a T1 squamous cell carcinoma of the vocal cord The right picture shows the immediate post- operative appearance of the vocal cords after surgical biopsy. This patient will be treated with full course radiation therapy and should have greater than a 90% chance of cure.
  • Slide 24
  • Laryngeal Carcinoma
  • Slide 25
  • The picture on the left is a cancer of the epiglottis or top of the voice box. The middle picture is a cancer of the true vocal cords and the picture on the far right is a cancer of the sub- glottis or below the vocal cords.