Laryngoscopy is the main kind of laryngeal research. The complexity of the method lies in the fact that the longitudinal axis of the larynx is located at a right angle to the axis of the oral cavity, because of which the larynx can not be inspected in the usual way. Inspection of the larynx can be performed either with the help of a laryngeal mirror (indirect laryngoscopy), in which the laryngoscopic picture is presented in the form of a mirror image or with the help of special directories for direct laryngoscopy.
Laryngeal palpation and the anterior surface of the neck is carried out at the usual position of the head and when it is thrown back while assessing the relief of the palpable region.
Pathological anatomy of the laryngeal scleroma.
The scleroma of the larynx begins with the formation of dense submucosal infiltrates, consisting of small rounded cells and plasmocytes, as well as a large number of spindle-shaped cells and fibroblasts that complete the formation of the scleral focus, turning it into a dense tumor. The cylindrical epithelial cells located above the infiltrate are transformed into a multilayer flat keratinizing epithelium. Sclerous infiltrates do not undergo decay, and the mucous membrane - ulceration.
Laryngeal syphilis is much less common than that of the nose or throat infection. Very rarely the larynx is affected by congenital syphilis. In rare cases with syphilis of the larynx, the primary affect (chancre) is localized on the epiglottis and aryepiglottic fold, where the pathogen comes from an external source with saliva.
In the primary period, there are enlarged epiglottis and aryepiglottic folds, as well as ulcers on the surface, regional lymphadenitis. Painless, densely elastic consistency enlarged lymph nodes are disintegrated with the formation of an external fistula.
Primary tuberculosis of the larynx is rare, it is often secondary to the primary localization of infection in the lungs, which occurs with the involvement of the intrathoracic lymph nodes. Tuberculosis of the larynx occurs in approximately 10% of patients with the initial form of pulmonary tuberculosis, in 30% of persons with a long course of this infection and in 70% of cases with the autopsy of those who died from it. Tuberculosis of the larynx affects children less often, and at the age of less than 10 years - very rarely.
Blastomycosis (Gilchrist's disease) is a group of chronic non-contagious diseases related to deep mycoses, affecting the skin, bones, mucous membranes and internal organs. The disease was called Gilchrist disease, named after the American dermatologist Thomas Casper Gilchrist (1862-1927), who has first described it.
Etiology of blastomycosis. The disease causes yeast and yeast-like fungi. The reservoir of pathogens of blastomycosis is the soil. Infection usually occurs by inhaling fungus spores with dust. Mostly sick people working in agriculture.
Sporotrichosis is a relatively rare human disease, affecting mainly the skin and subcutaneous tissue, in rare cases, spreading to the mucous membrane of the upper respiratory tract.
Laryngeal actinomycosis in most cases is associated with actinomycosis of the oral cavity and pharynx. In rare cases, the actinomycosis of the larynx occurs primarily in an isolated form.
Etiology. The causative agent is Actinomyces Bovis (actinomycete-ray fungus of cattle), however from the works of V. Racovenu it follows that the true activator of actinomycosis is the fungus Actinomyces Israeli.
Laryngeal thrush most often occurs in the summer in infants, especially with artificial feeding, as well as in children with eating disorders and in adults suffering from diabetes, cachexia, tuberculosis and other chronic infections that depress immunity.
In the larynx, fish and meat bones, dentures, small items, as well as living creatures: leeches, worms, can enter. Thin fish bones and metal needles, as a rule, pierce directly into the mucous membrane of the entrance to the larynx.
Foreign bodies of small size slip through the vocal chink into the trachea and bronchi. Foreign objects of a larger size can be fixed on the threshold of the larynx, in the lumen of the glottis or infringed in the underlying space.