Benign Laryngeal Lesions

5.2.1 Describe the different histologic layers of the true vocal fold and why they are important in voice production. 

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5.2.2 Give a detailed anatomic and physiologic description of the lamina propria.

5.2.3 What is Reinke’s edema? What does it signify? How should it be managed?

5.2.4 Where and what is the saccule?

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5.2.5 Endoscopic or open approach for treatment of saccular cysts? Marsupialization or excision?

5.2.6 Describe the classification of laryngoceles and the management of each. What underlying problem must be ruled out prior to definitive management of a laryngocele? 

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5.2.7 Discuss mucous retention cyst vs. epidermoid cysts of the vocal folds.

5.2.8 What is Sulcus vocalis?

Ford CN, Inagi K, Khidr A, Bless DM, Gilchrist KW. Sulcus vocalis: a rational analytical approach to diagnosis and management. Ann Otol Rhinol Laryngol. 1996 Mar;105(3):189-200. PMID:8615582

5.2.9 The MICU has just consulted you for post-extubation hoarseness in a chronically intubated patient. What will you most likely find and how will you manage the problem?

5.2.10 What are the most common types of human papilloma virus in respiratory papillomatosis? Which types are associated with squamous cell carcinoma?

5.2.11 How would you recommend resecting laryngeal papillomas? Laser, microdebrider, etc.?

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5.2.12 What is cidofovir? What are the results of intralesional cidofovir injection in laryngeal papillomas? Any side effects? Discuss routes of administration.

5.2.13 Discuss medical therapy for recurrent respiratory papillomatosis.

Avidano MA, Singleton GT. Adjuvant drug strategies in the treatment of recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg. 1995 Feb;112(2):197-202. PMID:7530830

5.2.14 You are referred a patient with worsened dysphonia after removal of vocal fold polyps. What is the pathophysiology of postoperative dysphonia? How will you manage this patient?

Benninger, MS. et al. Vocal fold scarring: current concepts and management. Otolaryngol Head Neck Surg. 1996 Nov;115(5):474-82. PMID:8903451

5.2.15 What are the guidelines for management of post-op vocal fold microsurgery (voice use, steroids, reflux prophylaxis, etc…)?