for any suggestions please call 0122358933. laryngeal examination indirect laryngoscopy laryngeal...

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Post on 17-Dec-2015




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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
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  • During phonation During quiet inspiration Base of the tongue Epiglootis Pyriform fossa Vocal foldsAry-epiglottic fold Arytenoid
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  • Laryngeal examination Flexible fiberoptic nasolaryngoscopy Flexible endoscopic Examination of -Nasal cavity -Hypopharynx -Larynx
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  • Rigid endoscopic examination of the larynx and hypopharynx
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  • 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
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  • Micro-laryngeal surgery The use of the operating Microscope in direct Laryngoscopy is called MICRO-LARYNGOSCOPY Advantage: Provides Magnification Provides good illumination
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  • Micro-laryngeal surgery employing laser Microscope Laryngoscope
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  • Abduction: The vocal cords are apart for breathing in. The rings of the trachea can be seen ( yellow arrow).
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  • During Phonation the vocal cords are adducted.
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  • Laryngeal Web Whitish band in the anterior part of the glottis Congenital laryngeal Web Presentation - Newly born with hoarse weak cry
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  • laryngomalacia The supraglottis is collapsing inwards during inspiration Presentation: -Inspiratory stridors -Starts soon after birth -Improves in prone position -Normal cry
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  • Subglottic Hemangioma May be accompanied with hemangiomas in other sites
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  • Posterior laryngeal cleft
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  • Intubation granuloma Causes Prolonged intubation Blind intubation
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  • Reinkes edema Voice abuse
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  • Vocal nodules
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  • Vocal polyp
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  • Multiple Papillomatosis
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  • Epiglottitis
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  • Croup
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  • Laryngoscleroma (subglottic web) Vocal cord Greenish crusts Vocal cord Rhinoscleroma Subglottic stenosis
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  • 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.
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  • Laryngeal Carcinoma
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  • 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.