Juvenile nasopharyngeal angiofibroma| aetiology, diagnosis, treatment

What are the symptoms of laryngeal diseases?

• Change of voice (dysphonia or hoarseness). 
• Dyspnea: difficulty in breathing.
• Stridor: difficult noisy respiration. 
• Pain: local or referred.
• Cough, expectoration, and hemoptysis. 
• Dysphagia.
• Chocking. 
• Swelling.

Examination of the larynx:

A. External Examination

• Inspection: position & movement, contour, swellings, and scars.
• Palpation: tenderness, crepitus, crepitation, swellings, laryngeal click

Side to side movement of larynx over the vertebral column, normally a click is felt, if lost (+ve Moure’s sign) … mass between larynx & vertebral column e.g. post cricoid carcinoma.

B- Indirect laryngoscopy(IL):

C. Flexible fiberoptic laryngoscopy:

• When I.L is difficult, it is introduced via the nose.
• Photographic documentation.

D. Direct laryngoscopy(DL) under GA:

• By rigid endoscope
• Operating microscope can be used

NB: -Any lesion affects laryngeal patency: stridor

- Any lesion affects vocal fold: dysphonia

Laryngeal investigations:

1. Direct laryngoscopy ± biopsy.
2. Radiology (X ray, CT and, MRI).

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