Laryngeal Mass: The two patients shown on the right have a supraglottic mass caused by a lymphoma ( a blood cell cancer ). In both patients, the mass was submucosal ( below the skin ). The photograph on the far right shows a mass protruding out over the true vocal cords , coming out of the laryngeal ventricle . The left hand picture shows a large supraglottic mass which is deep in the tissues of the larynx.
The picture on the right shows a 60 year old patient with a lymphoma arising from the left epiglottis and vallecula .
Vocal Cord Nodules: These nodules are similar to calluses on a worker's hands. They are caused by chronic straining of the voice. They are often called singer's or screamer's nodules. Speech therapy to train the patient to not abuse his/her voice is usually curative.
Adrenal corticosteroids exert a strong suppressive influence on the basic inflammatory response that leads to tissue swelling. The corticosteroid effect is nonspecific. In upper airway obstruction caused by edema from infection, allergy, or trauma, corticosteroids will exert some degree of suppressive effect. The steroid effect is local and directly proportional to the concentration of steroids in the inflamed tissue. In upper airway obstruction steroids should be delivered to the inflamed tissue in high concentration with the least delay. Dexamethasone and methylprednisolone produce high blood levels within 15 to 30 minutes of intramuscular injection. Recommended initial doses for acute airway obstruction are dexamethasone, to mg/kg, or methylprednisolone, 5 to 7 mg/kg. The risk of harm from steroid therapy of 24 hours or less is negligible.