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INVESTIGATION OF THE PHARYNX, LARYNX AND NECK Plain lateral radiographs Plain lateral radiographs of the neck and cervical spine may show soft-tissue abnormalities, although their sensitivity and specificity is low; of particular importance is the depth and H...

Introduction No content extracted automatically.

LARYNGEAL DISEASE CAUSING LARYNGEAL DISEASE CAUSING

LUMP IN THE NECK On presentation, a careful history and examination are essential. The clinical signs of size, site, shape, consistency , fixation to skin or deep structures, pulsation, compressibility , transillumination or the presence of a bruit must be es...

Laryngeal mask airway The laryngeal mask airway (LMA) is a wide-bore airway with an inflatable cu ff at the distal end, which forms a seal in the pharynx around the laryngeal inlet. Provided the laryngotra cheal airway is clear, the LMA provides a clear and secu...

Laryngeal papillomata These are rare benign tumours occurring mainly in children but can also present in adults. They are most commonly found on the vocal folds but may spread throughout the larynx and tracheobronchial airway (although this is less likely in a...

Laryngotracheobronchitis (croup) Croup is usually of slower onset than acute epiglottitis and occurs most commonly in children under 2 years of age. It is usually viral in origin and the cases often occur in clusters. The children have biphasic stridor and a...

Larynx It is important to appreciate that the main function of the larynx is not the production of voice but the protection of the tracheobronchial airway and lungs. In order to achieve this, the larynx, together with the base of the tongue, forms the prot...

Learning objectives To understand: The relevant anatomy, physiology, disease processes and • investigations of the pharynx, the larynx and the neck The diagnosis and emergency treatment of airway • obstruction Learning objectives To understand: The relevant an...

Malignant The most important epithelial tumour is squamous cell carci noma, which constitutes approximately 90% of all epithelial tumours in the upper aerodigestive tract ( Figures 52.35 and 52.36 ). In the oropharynx, the proportion is less (70%) because of ...

NASOPHARYNX Enlarged adenoid The most common cause of an enlarged adenoid (there is only one nasopharyngeal adenoid, despite the common use of the term ‘adenoids’) is physiological hypertrophy in childhood. The size of the adenoid alone is not an indication...

Neck The neck is divided into anterior and posterior triangles by ). the sternocleidomastoid muscle. The anterior triangle extends from the inferior border of the mandible to the sternum below and is bounded by the midline and the posterior border of the ster...

Nerve supply The sensory nerve supply to the larynx above the true vocal folds is from the internal branch of the superior laryngeal nerve and, below , it is from the recurrent laryngeal nerve. Both these nerves are branches of the vagus nerve (X). The motor...

Neurovascular injury Penetrating wounds of the neck may involve the common - carotid or the external or internal carotid arteries. Major haemorrhagic shock may occur. V enous air embolism may occur because of damage to one of the major veins, most commonly ...

OROPHARYNX Acute tonsillitis This common condition is characterised by a sore throat, fever, general malaise, dysphagia, enlarged upper cervical nodes and sometimes referred otalgia. Approximately half the cases are bacterial, the most common cause being a py...

OTHER EMERGENCY AIRWAY PROCEDURES OTHER EMERGENCY AIRWAY PROCEDURES

Obstructive sleep apnoea This condition is becoming increasingly diagnosed in children and is important because it can cause sleep deprivation and secondary cardiac complications. It has been implicated in some cases of sudden infant death syndrome. The most ...

Other causes of acute pharyngolaryngeal oedema Angioneurotic oedema, radiotherapy and laryngeal trauma associated with road tra ffi c accidents, corrosives, scalds and smoke ingestion may all cause significant pharyngolaryn - geal oedema, in addition to the acute...