Benign tumors of the larynx: causes, symptoms, diagnosis, treatment

[1]

Chondroma of the larynx

Laryngeal chondroma is a very rare disease in otolaryngology are almost always localized on the plate of cricoid cartilage, from which, spreading, penetrates into various areas of the larynx. Romanian otorhinolaryngologists found that in 1952 only 87 cases of this disease were described in the world literature. Less commonly, laryngeal chondroma develops on the epiglottis and thyroid cartilage.

[2],

Pathological anatomy of laryngeal chondroma

With the development of chondromas on the thyroid cartilage, they, as a rule, penetrate the front surface of the neck and palpation becomes available. Usually, these tumors are well separated from the surrounding tissues, have a rounded shape, are covered with normal mucous membrane from the inside, and outside (chondroma of the thyroid cartilage) are not fused with normal skin; They are characterized by a considerable density, which prevents biopsy, therefore, for biopsy, they often resort to thyrotomy with simultaneous surgical treatment. In indirect laryngoscopy, only the chondromas of the upper larynx can be examined. Their detailed visualization is possible only with direct laryngoscopy.

[3], [4], [5], [6], [7], [8]

Symptoms of laryngeal chondroma

The symptoms of laryngeal chondroma depend on the location of the tumor and its size. Chondromas of the cricoid cartilage plate cause breathing and swallowing disorders, as they constrict the sub-storage space and squeeze the hypopharynx. Laryngeal chondromas can degenerate into malignant tumors - chondrosarcoma. Chondromas of the thyroid cartilage, with their endophytic growth, cause impairment of voice formation and, with significant size, respiration. In chondroma of the epiglottis, its locking function may be impaired when swallowing, with the appearance of a gagging phenomenon.

[9], [10]

Diagnosis of laryngeal chondroma

In laryngeal chondromas, an x-ray examination of the larynx is required to determine the location and extent of the tumor.

Treatment of laryngeal chondroma

Treatment of laryngeal chondroma is surgical in all cases. With endolaryngeal chondromas, preliminary tracheotomy and general anesthesia are shown with tracheal intubation through the tracheostomy. The tumor is removed by external access (tyrotomy) and intrathoracic, observing, if possible, the principle of sparing the laryngeal tissues necessary to preserve its respiratory lumen and voice function. Some authors recommend to carry out radiotherapy after surgery to prevent relapses, which may occur during incomplete removal of the tumor.

Lipoma Larynx

Lipoma of the larynx occurs extremely rarely, it can be localized on the epiglottis, the laryngeal folds, in the ventricles of the larynx; in other cases it comes from the laryngeal part of the pharynx, from where it spreads on the eve of the larynx; may be multiple. Lipoma of the larynx has the form of a rounded formation with a smooth or lobed surface of a bluish color.

[11]

Symptoms of lipoma lipoma

Symptoms of the laryngeal lipoma depend on the location and size of the tumor; breathing is more common than phonation.

[12], [13], [14]

Diagnosis of the laryngeal lipoma

Diagnosis of the lipoma of the larynx is possible only after the removal of the tumor and its histological examination.

[15]

Laryngeal lipoma treatment

Small tumors are removed by cautery or laser. Large - from external access (pharyngitis, thyrotomy).

[16],

Laryngeal adenoma

Laryngeal adenoma is an extremely rare tumor, the diagnosis of which can be established only after its removal and histological examination.

The structure of the tumor is represented by a variety of glandular tissues and in appearance can be mistaken for a glandular polyp or adenocarcinoma.

[17], [18]

Treatment of laryngeal adenoma

Treatment of laryngeal adenoma surgical.

Myxoma larynx

Myxomatous elements may be present in some forms of laryngeal polyps and, depending on their relative volume, may be referred to as myxomatous polyps, larynx myxoma or fibromyxoma. In most publications, this type of tumor does not stand out as a nosological and morphological form.

[19], [20], [21], [22]

Treatment of laryngeal myxoma

Treatment of larynx myxoma surgical.

Laryngeal fibromyoma

Laryngeal fibromyoma - a tumor that is extremely rare; It comes from the muscle tissue of the internal muscles of the larynx and is most often located on the back or side of the cricoid cartilage, from where it spreads to the nadgorny folds and the eve of the larynx.

[23]

Symptoms of fibroids of the larynx

A tumor can reach the size of a walnut and sometimes penetrate into the lateral region of the neck at the level of the shield-sublingual membrane. In appearance, it may resemble a cyst, aberrant goiter, chondroma. Laryngeal fibromyoma may degenerate into myosarcoma.

[24], [25], [26]

Laryngeal fibromyoma treatment

Treatment of laryngeal fibromyoma surgery.

[27], [28], [29]

Laryngeal neuroma

Laryngeal neuroma is a tumor originating from the vertebral nerve and localized above the vocal folds, at the entrance to the larynx. The tumor has the appearance of a rounded education with a smooth surface, from pink to dark red.

Laryngeal neuroma may occur as a single formation as a result of the proliferation of the specified nerve's lemmocytes (benign schwannoma), but may be a systemic disease of the Recklinghausen neurofibromatosis type, which is a hereditary disease of undifferentiated nervous tissue (autosomal dominant inheritance).

[30],

Symptoms of laryngeal neuroma

The disease usually occurs in childhood; there are pigment spots of the color “coffee with milk”, multiple painless neurofibromas (symptom of the “bell button”); neurogliomas are observed in the area of the nerve bundles (especially the neck and hands); often eyelid. The appearance of fibromatous nodes in the spinal cord and brain give the appropriate symptoms. Multiple fibromatous lesions in the bones are combined with general degenerative changes and abnormalities, especially of the skeletal system. The disease can be associated with impaired vision and hearing, dementia, curvature of the spine.

Nodes can squeeze adjacent organs, causing impairment of their function. So with localization on the neck or mediastinum, disorders of respiration, blood circulation and lymph flow can be observed. Men get sick twice as often.

The presence of these symptoms or part of them helps to suspect the presence of laryngeal neuroma with the appearance of "guttural" symptoms.

[31], [32], [33], [34], [35], [36]

Treatment of laryngeal neuroma

In the presence of solitary neuroma in the larynx, not associated with systemic neurofibromatosis and causing functional impairment, ce removal is shown. In a systemic disease, the removal of laryngeal neurofibroma should be radical, since its residues can quickly recur or even degenerate into a malignant tumor.

What is the prognosis of laryngeal neuroma?

The prognosis is usually favorable, malignancy rarely occurs. During malignancy, the node quickly grows, squeezes the surrounding tissues and grows into them, causing a clinical picture of a malignant tumor of the larynx.

Laryngeal amyloidosis

Laryngeal amyloidosis is a rare disease, the etiology of which is not entirely clear. In some cases, combined with amyloidosis of other organs. In 75% of cases, it affects male subjects. Amyloid formations are isolated rounded formations, translucent through the mucous membrane of the larynx bluish color; do not disintegrate and do not cause pain; when localized on scarp-like cartilage, they cause a disturbance of the voice formation. Giant multinucleated cells agglomerate around the amyloid formations - a reaction to a foreign amyloid substance.

[37], [38], [39]

Diagnosis of laryngeal amyloidosis

Diagnosis of amyloidosis of the larynx does not cause difficulties, however, requires confirmation by histological method. ATBondarsnko (1924) proposed an original method for the diagnosis of laryngeal amyloidosis by intravenous administration

10 ml of 1% congo red solution. Amyloid tumor after 1 h acquires an orange color, and after 2 hours it is intensely colored red.

[40], [41], [42]

Treatment of laryngeal amyloidosis

Treatment of laryngeal amyloidosis surgical. Relapses are very rare.

What is the prognosis of laryngeal amyloidosis?

Amyloidosis of the larynx has a favorable prognosis. In the case of systemic amyloidosis, the prognosis is serious because of the dysfunction of the liver, kidneys, and cachexia.