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Of Burns

The application of the lunar caustic in recent burns or scald...

Infants' Sleep

See Children's Sleep. ...

Glands Of Bowels

See Bowels. ...


No dyspneic patient should be given a general anesthetic; be...


How Nuts should be Used. Another form of fat is the meat of ...

Malignant Disease Of The Esophagus

Cancer of the esophagus is a more prevalent disease than is c...

Children's Clothing

An infant's clothing should be soft, warm, and light in weight...


See Narcotics. ...

Where There Is A Will There Is A Way!

I have been frequently compelled to resort to these milder ap...

Prejudice Of Physicians Against The Water-cure

The greatest, and the most serious, difficulty lies in the pr...

Proteins Or Meats

Proteins, the First Foods. There are proteins, or meats, both...


Treat exactly as in acute diarrh[oe]a, except that P. P. shou...


acts favorably on cancers, and is a specific when applied to ...

Spring Trouble

Many persons are distressed by some form of eruption or inflam...

Our Feet

The Living Arches of the Foot. One of the most important thin...


In the non-cicatricial forms, galvanocaustic puncture applie...

The Fulcrum Of The Bronchoscopic Lever Is At The Upper Thoracic Aperture

Disregard of this rule will cause subglottic edema and will ...


_This is preaching rebellion!_ I know it is, and it is wit...

Treatment Of Scarlatina Anginosa Or Sore-throat Scarlet-fever

In _scarlatina anginosa_, or _sore-throat scarlet-fever_, whi...

Temperature Of The Water Double Sheet Changing Sheet

The water for the wet-sheet pack, in this violent form, ought...

Benign Growths In The Larynx

Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

Benign growths in the larynx are easily and accurately removable by
direct laryngoscopy; but perhaps no method has been more often misused
and followed by most unfortunate results. It should always be
remembered that benign growths are benign, and that hence they do not
justify the radical work demanded in dealing with malignancy. The
larynx should be worked upon with the same delicacy and respect for
the normal tissues that are customary in dealing with the eye.

Granulomata in the larynx, while not true neoplasms, require
extirpation in some instances.

Vocal nodules, when other methods of cure such as vocal rest,
various vocal exercises, etcetera have failed may require surgical
excision. This may be done with the laryngeal tissue forceps or with
the author's vocal nodule forceps. Sessile vocal nodules may be cured
by touching them with a fine galvanocautery point, but all work on the
vocal cords must be done with extreme caution and nicety. It is
exceedingly easy to ruin a fine voice.

Fibromata, often of inflammatory genesis, are best removed with the
laryngeal grasping forceps, though the small laryngeal punch or tissue
forceps may be used. If very large, they may be amputated with the
snare, the base being treated with galvanocautery though this is
seldom advisable. Strong traction should be avoided as likely to do
irreparable injury to the laryngeal motility.

Cystomata may get well after simple excision or galvanopuncture of a
part of the wall of the sac, but complete extirpation of the sac is
often required for cure. The same is true of adenomata.

[202] Angiomata, if extensive and deeply seated, may require deep
excision, but usually cure results from superficial removal. Usually
no cauterization of the vessels at the base is necessary, either to
arrest hemorrhage or to lessen the tendency to recurrence. A diffuse
telangiectasis, should it require treatment, may be gently touched
with a needle-pointed galvanocaustic electrode at a number of
sittings. The galvanonocautery is a dangerous method to use in the
larynx. Radium offers the best results in this latter form of angioma,
applied either internally or to the neck.

Lymphoma, enchondroma and osteoma, if not too extensively involving
the laryngeal walls, may be excised with basket punch forceps, but
lymphoma is probably better treated by radium.* True myxomata and
lipomata are very rare. Amyloid tumors are occasionally met with,
and are very resistant to treatment. Aberrant thyroid tumors do not
require very radical excision of normal base, but should be removed as
completely as possible.

In a general way, it may be stated that with benign growths in the
larynx the best functional results are obtained by superficial rather
than radical, deep extirpation, remembering that it is easier to
remove tissue than to replace it, and that cicatrices impair or ruin
the voice and may cause stenosis.

* In a case reported by Delavan a complete cure with perfect
restoration of voice resulted from radium after I had failed to cure
by operative methods. (Proceedings American Laryngological
Association, 1921.)

Next: Papillomata Of The Larynx In Children

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