Pathology of benign laryngeal tumours (polyps, fibroids, papilloma)

2021-02-01 12:00 AM

Polyps have stalks on the free margin or vocal cords. When the patient breathes, the glottis opens, the polyps may fall down below the vocal cords, difficult to detect when examined.

There are many types of small tumours in the larynx: laryngeal polyps, laryngeal fibrosis, laryngeal papilloma’s (papilloma), cysts, blood tumours ... We present three common types of laryngeal tumours that are laryngeal polyps. laryngeal fibrous granules and laryngoma.

Laryngeal polyps

Are small tumours in the larynx due to oedema, degeneration of the mucosa or overproduction of the epithelial organization or connective organization?

Symptom

Function

Hoarseness is the main thing; speaking is a bit tired.

The larger polyps make the opening of the glottis when speaking, the hoarser the voice, the tired speech, the patient cannot speak for long.

Polyps have stalks on the free margin or on the vocal cords when the patient's voice is flipped.

Rarely see patients lose voice and difficulty breathing larynx due to polyps.

Entity

U is as big as a grain of rice, green bean or corn.

Light pink in colour, soft in heart or hard white in colour.

Growth in the vocal cords or vocal cords.

Polyps may or may not be stalked. Polyp (polypose) disease, polyp often spread over a large area of ​​the larynx, removed it is easy to regrow.

If the polyp is stiff on the free margin of the vocal cord, it is possible that the foreign body is causing a dent in the vocal cord opposite. The mucosa around the polyp's legs is often congested.

Polyps have stalks on the free margin or vocal cords. When the patient breathes, the glottis opens, the polyps may fall down below the vocal cords, difficult to detect when examined. When pronouncing polyps on the surface of the vocal cords, during examination tell the patient to breathe alternately with the sound "ê" or "i" for easy observation.

Differential diagnosis

Based on clinical and anatomical pathology:

Fibroid: usually grows on the free margin of vocal cord. The composition is the fibrous organization, can be mixed with fat, blood vessels.

Mucous tumour (myxoma):

Fake myxoma: small soft, succulent.

True myxoma: in a jelly-like swarm in the vocal cords or vocal cords.

Cyst: opaque white just below the epithelial layer, inside containing thick mucus, usually in the vocal cord.

Vascular tumours: dark, lumpy, easy to bleed to the touch.

Ventricular flux: swelling of the ventricular mucosa is excessively sagging down toward the glottis.

Prognosis

Mainly affects the patient's voice. Especially, the patient is a shopkeeper, teacher, singer ...

The disease is not malignant, does not endanger the patient's life, but does not cure on its own. Conservative treatment with few results.

Treatment

Surgery to remove polyps

There are many methods.

Indirect laryngoscopy cuts polyps with Frankel pliers for polyps with small stalks. Currently this method is rarely used.

Direct laryngoscopy removes polyps with laryngeal microsurgery.

Laryngoscopy (direct laryngoscopy with bronchoscope hanging).

It can be done in various forms

Removal of polyps under a surgical microscope (microsurgery).

Remove polyp by CO2 laser.

Insensitivity

Pre-love, numbness in place.

Endotracheal anaesthesia.

After surgery

Antibiotic.

In the case of small polyps or polyps with stalks when cut, the mucosa of the larynx has little damage, only antibiotics are needed.

In the case of large polyps and non-stemless polyps, peel off the vocal cord mucosa, laryngeal lesions are much oedema for injectable antibiotics.

Anti-inflammatory, anti-oedema.

Nebulized

Hydrocortisone 125 mg x 1 vial

-chymotrypsin x 3 ampoules

Gentamycin 80 mg x 3 ampoules

Mixing aerosols for 7 days.

Lean seed

Outline

Stringer seed is a small lump of broken grain, rice grain, and wheat grain that grows on the free bank of the vocal cord positioned at the front and middle 1/3.

Laryngeal fibres include 1 fibrous nucleus, in addition to the overproduction epithelium.

Maybe 1 side of the vocal cord or 2 sides of the vocal cord are symmetrical. When pronounced they touch each other, so it is called a kiss nodule.

The disease is common in adults, can also be found in children.

The cause is voice abuse and laryngitis.

Symptom

Function

Mostly hoarseness.

Initially, it was periodic hoarseness, treatment and speech restriction was given, but in addition to the voice, it was possible to return to normal, because the free vocal cord mucosa was just too strong and not fibrous, so it was able to recover. back to normal. After continuous hoarseness.

Mild, moderate, or severe hoarseness may be mild, depending on the large and small vocal cord particles and the degree of vocal cord weakness.

Speech loss, due to the glottis opening when speaking.

Entity

Indirect laryngoscopy:

String grain is as big as broken grain, 1/2 grain of rice, wheat grain is on the free bank of string, front and centre. It can be symmetrical or on one side.

When pronounced there are 2 glottic slits, one at the front 1/3 and the other 2/3 after. Can see vocal defect, rhombic or triangular cleft palate.

Chronic inflammation of the vocal cord mucosa is common.

Prognosis

The disease lasts for a long time but does not cause danger to life.

Treatment

Conservative treatment: when the fibrous kernels are not fibrous, the new vocal cord mucosa is too developed and can be resilient.

Treatment is as follows

Antibiotic.

Anti-inflammatory, anti-oedema (corticoid), nebulizer or laryngeal medicine.

Take a break from speaking and singing for a few weeks.

Surgical treatment: when the fibrous fibrosis seeds are fibrosis (continuous hoarseness, ineffective treatment ...)

Hanging laryngoscopy removes vocal cords with microsurgical pliers or by CO2 lasers.

After surgery, the above treatment and the patient stopped talking for 1 week.

Laryngeal papilloma
(see post laryngeal papilloma).