LARYNX &PHARYNX Presentation & Diagnosis of Disease

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Presentation transcript:

LARYNX &PHARYNX Presentation & Diagnosis of Disease Dr. M. Abdel-Rauf Masoud Professor of Otolaryngology Ain Shams University

Presentation (symptoms)

Nasopharyngeal diseases Symptoms: Nasal: Obstruction, discharge, bleeds, Nasal tone of voice,.. Aural: blockage, earache,.. Others: neck nodes, cranial nerves, ocular,..

Oropharyngeal disases Symptoms: Swallowing problems: 1. Dysphagia 2. Nasal regurge of food Pain: Sore throat; may be referred to ears. Nasal tone of voice. Snoring.

Hypopharyngeal diseases Symptoms: Dysphagia. Laryngeal: hoarseness, aspiration. Neck lump: LNs, pharyngocele. Pain: referred to ear.

Laryngeal diseases Symptoms: Hoarseness of voice (dysphonia) Respiratory obstruction (stridor) Cough Aspiration (choking) Pain Dysphagia Others: Neck mass, spitting of blood,..

Nasality (nasal tone of voice) Disturbed resonance. Decreased resonance (closed nasality) by nasopharyngeal obstructing SOLs. Resonance of non-resonating consonants (open nasality) in cleft, short, or paralyzed palate.

Nasal regurge of food Escape of food (mainly fluids) into the nose during swallowing. Palatal problem: short, cleft, perforated, or paralyzed palate.

Dysphagia: Difficulty, pain, or even sense of awareness, during any phase of deglutition. Odynophagia (painfull swallowing). Towards solids or fluids (or both). Absolute dysphagia!, regurge of food!

Swallowing is not always an easy task!!

Snoring A sound produced by vibrations of the soft palate & pharyngeal walls due to partial upper airway obstruction. Sleep apnea: attacks of arrest of breathing due to complete upper airway obstruction during sleep.

Stridor A musical (high pitched) sound produced due to marked airway obstruction at the level of the larynx or upper trachea (sometimes the pharynx). Emergency!!!

Examination

Clinical Examination: 1. Nasopharynx Finger palpation: An old method. Not to be used… Unhuman !!!

Clinical Examination: 1. Nasopharynx Mirror examination: Needs good patient’s cooperation. Sometimes very difficult.

Clinical Examination: 1. Nasopharynx Flexible endoscopy: Used for nose, pharynx & larynx.

Clinical Examination: 2. Oropharynx By tongue depressor. Flexible endoscopy.

Clinical Examination: 3. Larynx & hypopharynx External examination: Inspection (for position, swelling, deformity, movement with deglutition) Palpation (for tenderness, deformity, laryngeal click) Examination of other regions of the neck (specially for LNs)

Clinical Examination: 3. Larynx & hypopharynx Laryngeal mirror:

Clinical Examination: 3. Larynx & hypopharynx Rigid telescope

Clinical Examination: 3. Larynx & hypopharynx Flexible endoscopy: Used for nose, pharynx & larynx.

Investigations

Investigations Radiology: 1. Plain X-rays. 2. Ba swallow. 3. CT & MRI. Endoscopy under GA (to see & take biopsy).

Plain X-ray lat. view for nasophx

Plain X-ray lat. view neck

Barium swallow

Barium swallow

CT & MRI

CT & MRI

Direct endoscopy

THANK YOU…