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Laryngeal disease symptoms, examination and investigations

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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