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Larynx (Voice Box) Pictures
Larynx (Voice Box) Pictures
Voice Box (Larynx) Pictures   

Normal Voice Box (Larynx)  

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Normal Larynx or Voice Box  Normal larynx or Voice Box  Normal Larynx or Voice Box

Fish Bone Foreign Body Lodged in LarynxLarynx Foreign Body -- Fish Bone:
  Foreign bodies lodged in the larynx is a medical emergency.  The patient has extreme discomfort and airway compromise from laryngeal obstruction or spasm may occur.
Click on picture to enlarge


Leukoplakia of the Larynx - True Vocal CordsLeukoplakia of the Larynx - True Vocal CordsVocal Cord Leukoplakia:  This is a condition caused by chronic irritation which results in abnormal growth of the top layer of the skin lining the vocal cords.   It is often seen in smokers and is considered a pre-cancerous condition.  The picture on the far right shows severe leukoplakia which upon biopsy was found to be a squamous cell carcinoma (see right hand photograph below in cancer section).  The picture on the left shows mild leukoplakia around a small mucosal contact ulcer. 
Click on picture to enlarge


T1 Squamous Cell Carcinoma of the True Vocal CordsT3 Squamous Cell Carcinoma with Fixation of the Left True Vocal CordsCancer of the Voice Box (Larynx):  The picture to the far right is a T1 cancer, confined to the vocal cord.  The left had picture shows a T3 larynx cancer.  A T1 glottic cancer is confined to the vocal cords.  A T3 glottic cancer fixes the mobility of the vocal cord.  Larynx cancers which start on the vocal cords produce symptoms of hoarseness.  Even very small tumors produce symptoms.  They are thus often diagnosed very early and at this stage have a 90% cure with either conservative surgery or irradiation with or without chemotherapy.
Click on picture to enlarge

Supraglottic Cancer of the LarynxSupraglottic Cancer of the LarynxSupraglottic cancer is a cancer confined to the top of the larynx or epiglottis.  This cancer is often silent and does not cause symptoms until very late.  Often the patient will present with a neck node.   The pictures shown below are from four patients with Squamous Cell Carcinoma of the supraglottis (top part of the voice box).    Click on picture to enlarge



T1 Supraglottic Cancer of the LarynxSupraglottic Cancer of the LarynxClick on pictures to enlarge

Pyriform Sinus and Larynx CancerPyriform Sinus and Larynx CancerPyriform Sinus and Larynx CancerPyriform Sinus Cancer:  The picture is from a 77 year old patient who had a 30 pack year history of smoking.  He quite smoking 26 years ago.  The picture  shows a large pyriform sinus cancer.  The  pyriform sinus is located in the hypopharynx between the throat and the esophagus (food tube).  The cancer can be seen eating into the patient's voice box.

Search PubMed for Larynx Cancer  
Search Available Books for Quitting Smoking   for larynx Cancer    for Death and Dying      

Excellent Book: Living With The End In Mind 

Vocal Cord PolypsVocal Cord PolypsVocal Cord Polyps: 
This is a severe case of true vocal cord polyps.  This patient was a heavy smoker.  Surgical removal was necessary.  The surgery will improve the patient's voice and airway but will not restore the patient's voice to normal.  Search PubMed for Vocal Cord Polyps 


Vocal Cord PolypsSevere vocal cord polyps can cause airway obstruction.  To the right is a patient with severe vocal cord polyps.  The polyps are blown above and sucked below the cords as the patient breaths.
Mouse over picture to see polyps as patient exhales


Vocal Cord PolypsThe patient on the right has massive vocal cord polyps.  She was a heavy smoker.  The preoperative vocal cord polyps and the immediate postoperative result are shown in the pictures to the right.  During surgery, the mucosa of the polyp was incised along the lateral true vocal cord and the contents of the polyp was removed.  The excess mucosa was trimmed with a pair of micro scissors and the remaining mucosa was draped over the
true vocal cord

Larynx polyp on the left true vocal cordThe patient on the right has a large laryngeal polyp of the left true vocal cord.   The patient was a 50 year old female who had a 40 pack year history of smoking.

Large Nodule of the LarynxTo the left is a picture of the post-operative specimen   
Click on pictures to enlarge


Arytenoid GranulomaArytenoid GranulomaArytenoid Granuloma This is a condition of a benign growth over the cartilage that the vocal cord attaches to.  It is caused by chronic irritation, usually from gastroesophageal reflux.  Treatment consists of removal of the granuloma, controlling the patients acid reflux, along with speech therapy.  Search PubMed for Arytenoid Granuloma

The pictures below shows the preoperative view of a large
arytenoid granuloma and the post-operative specimen.  The granuloma was removed at surgery and the surrounding tissue injected with kenalog (a steroid).  The patient was treated with an ant-acid (proton-pump inhibitor).  At 3 months post-op, there has been no recurrence.

Arytenoid Granuloma - Post Op  Arytenoid Granuloma  Arytenoid Granuloma

Vocal Cord Edema (Swelling)Gastroesophageal Reflux:  This patient has chronic hoarseness and mild vocal cord erythema (redness) and edema (swelling).  This patient still smokes and had smoked one pack per day for 30 years and has gastroesophageal reflux disease (GERD).  Smoking also is a risk factor for gastroesophageal reflux.  Stopping smoking would help her larynx by eliminating the toxic effects of cigarette smoke and by helping to reduce the gastroesophageal reflux

True Vocal Cord Cyst of the LarynxTrue Vocal Cord Cyst of the LarynxVocal Cord Cyst:  This is a rare condition caused by vocal cord trauma.  Microsurgical removal is required to restore the patient's voice.

Epiglottic Mucosal CystThe picture to the right shows a large mucosal cyst forming between the epiglottis and the base of the tongue.  These cysts are more common in smokers and rarely, these cysts can reach a size as to obstruct the airway.  Surgical excision is advisable. 

True Vocal Cord CystTrue Vocal Cord CystShown here is an intra-operative photograph of a laryngeal cyst, before and after removal.       How to treat:  View Article

Search PubMed for Vocal Cord Cyst

Larynx CystLarynx CystLaryngeal Mucosal Cyst:  Cysts can occur on the voice box.  The most common place is on the epiglottis, found in the superior part of the voice box.   It they enlarge they can cause airway obstruction.



Laryngocele:  The picture on the right shows a large cyst in a 6 yr old girl.  The cyst was originating deep in the larynx, in the laryngeal ventricle.  She was experiencing hoarseness and breathing difficulties on exertion. 

The picture on the right shows a laryngocele in a 45 year old female.

Lymphoma of LarynxLymphoma of LarynxLaryngeal 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.



Lymphoma of LarynxLymphoma of LarynxThe 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.

   Search PubMed for Vocal Cord Nodules

Vocal Cord Nodules   Vocal Cord Nodules  Vocal Cord Nodules

Voice Box Mass - Large Vocal Cord NoduleLarynx Mass - Large Vocal Cord NoduleSevere vocal cord nodules can develop and become large and pendular.  The nodule shown in the two photographs to the right flops above and below the true vocal cords as the patient talks.  The patient was an avid sports fan and strained his vocal cords during sports events.   Click on pictures to enlarge

View Short Video of The
Mass (No Sound)
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Juvenile Laryngeal Papillomatosis:  This is a laryngeal growth caused by a virus.  It is passed to the child as he passes through the mother's birth canal.  Its growth can be very aggressive and can suffocate the child.  Many operative procedures are often required for their removal.  In this patient, he was finally stabilized after receiving Indol-3-Carbinol.  Several authors have reported success in treating papillomas with the antiviral agent Cidofovir   View Article  View Article .   In 2004, chraff et.a. reviewed the various therapies for juvenile laryngeal papillomatous. View Article
Search PubMed for Juvenile Laryngeal Papillomatous   
Search PubMed for Indol-3-Carbinol



Papillomas can also occur in adults.  Papillomas in adults tend to grow slower but still need operative removal.  Like there "juvenile" counterpart they are caused by a virus.  The pictures on the right are take form a 58 year old who has progressive difficulty breathing.  She had a previous surgery to remove papillomas three years ago. 

Laryngeal Trauma:  This patient fell and hit her neck.  She developed a hoarse voice.  On laryngeal exam a hematoma was noted of the true and false vocal cords.

The photograph on the right is taken from a 40 year old who experienced hoarseness and throat pain while weight lifting.  Note the swelling and mild hemorrhage of the left true vocal cord

Vocal Cord Ecchymosis for a Traumatic IntubationVocal Cord Ecchymosis:  This is a picture of a larynx form a patient who had traumatic intubation one week prior to the picture.  Note the residual hemorrhage under the mucosa of the vocal cords. 

Collapse of Hypopharynx with Muller's ManeuverCollapse of the Hypopharynx:  This picture shows a very narrow hypopharynx with collapse of the lateral walls with forced negative pressure (Muller's Maneuver).  The picture is taken at the moment of greatest observed airway.  This patient had severe sleep apnea.

Epiglottitis This is an infection of the epiglottitis, or top part of the larynx (voice box).  In children, this infection, can be very dangerous and cause complete airway obstruction.  In children, the causative bacteria is Haemophilus Influenza but since the advent of the Haemophilus Influenzae B vaccine the disease is seldom seen.   It can still occur in adults, where a number of different bacteria can cause the infection.  Symptoms include, rapid progression, high fever, drooling, inspiratory strider, and difficulty breathing when supine (on ones back).  The picture on the right shows a mildly swollen epiglottitis in a 17 year old male who presented with a sore throat and mild difficulty breathing when he laid down.

Search PubMed for Epiglottitis

Epiglottitis in an adult.  Epiglottitis is inflammation and swelling of the upper part of the larynx (voice box).  This disease is rare in children since the advent of the H. Influenza vaccine.  However, it can still occur.  In the adult, epiglottis can be caused by a variety of bacteria.  This patient was a 50 year old male who had symptoms for about 12 hours.  He was treated with cephuroxime and steroids and was discharged from the hospital 48 hours later.

Hemangioma of the larynx Shown in this photograph is a hemangioma on the posterior cricoid.  A hemangioma is a benign growth of blood vessels.  The patient was an adult and the hemangioma had not changed its size in years.  No treatment was necessary.  In children, hemangiomas most often occur in the subglottis area between the larynx and trachea.  In this region they can present an airway emergency.  They are usually removed using a laser. 
Trachea Granulation TissueTracheal Granulation Tissue:  Shown in the left picture is a patient's trachea (the windpipe below the larynx).  Chronic trauma from a breathing tube has formed granulation tissue.  If let untreated, narrowing of the trachea can occur.  The photograph on the right shows the patient's trachea after treatment with antibiotics and removal of the breathing tube. 

Click on pictures to enlarge



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