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Benign Growths In The LarynxCategory: 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 Previous: Pleuroscopy For Disease
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