The first sign of such an illness is a brief and slight attack...
Cramp In The Stomach
This very severe trouble, though resisting ordinary methods of...
_Small-pox_, by far the most dangerous of them, has found a b...
Use Of The Long Cord
It is often desirable to bring the entire parts of the patien...
Plate V Laryngeal And Tracheal Stenoses:
1, Indirect view, sitting position; postdiphtheric cicatricia...
Position For Bronchoscopy And Esophagoscopy
The dorsally recumbent patient is so placed that the head an...
The first decision to be made is what constitutes a slow puls...
Oxygen Tank And Tracheotomy Instruments
Respiratory arrest may occur from shifting of a foreign body,...
Smoking, a Senseless Habit. Smoking is the curious act of dra...
Myocarditis Fibrous Management
The advice he should receive is well understood: to avoid phy...
See Band, Flannel. ...
Is the process whereby the digested food is carried into the b...
Medicinal Runic Inscriptions
The discovery of the script of the ancient Germans, suppose...
ONCE met a man who had to do an important piece of sc...
Contraindications To Esophagoscopy
In the presence of aneurysm, advanced organic disease, exten...
Errors To Avoid In Suspected Foreign Body Cases
1. Do not reach for the foreign body with the fingers, lest...
Ulcers Case Xxx
C. Cocking, aged 17, has an ulcer of the size of half-a-crown...
Take A D current, of very mild force. Place P. P. at the feet...
Where we prescribe this, either for drinking or for external u...
The regular type of laryngoscope shown in Fig. I (A, B, C) i...
Differential Diagnosis Of Laryngeal Growths In The Larynx Of Adults
Category: ENDOSCOPY IN MALIGNANT DISEASE OF THE LARYNX
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Determination of the nature of the lesion in these cases
usually consists in the diagnosis by exclusion of the possibilities,
2. Tuberculosis, including lupus.
4. Malignant neoplasm.
In the Bronchoscopic Clinic the following is the routine procedure:
1. A Wassermann test is made. If negative, and there remains a
suspicion of lues, a therapeutic test with mercury protoiodid is
carried out by keeping the patient just under the salivation point for
eight weeks; during which time no potassium iodid is given, lest its
reaction upon the larynx cause an edema necessitating tracheotomy. If
no improvement is noticed lues is excluded. If the Wassermann is
positive, malignancy and the other possibilities are not considered as
excluded until the patient has been completely cured by mercury,
because, for instance, a leutic or tuberculous patient may have
cancer; a tuberculous patient may have lues; or a leutic patient,
2. Pulmonary tuberculosis is excluded by the usual means. If present
the laryngeal lesion may or may not be tuberculous; if the
laryngoscopic appearances are doubtful a specimen is taken. Lupoid
laryngeal tuberculosis so much resembles lues that both the
therapeutic test and biopsy may be required for certainty.
3. In all cases in which the diagnosis is not clear a specimen
is taken. This is readily accomplished by direct laryngoscopy under
local anesthesia, using the regular laryngoscope or the anterior
commissure laryngoscope. The best forceps in case of large growths are
the alligator punch forceps (Fig. 33). Smaller growths require tissue
forceps (Fig. 28). In case of small growths, it is best to remove the
entire growth; but without any attempt at radical extirpation of the
base; because, if the growth prove benign it is unnecessary; if
malignant, it is insufficient.
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