1. LARYNX &PHARYNX Presentation & Diagnosis of Disease
Dr. M. Abdel-Rauf Masoud
Professor of Otolaryngology
Ain Shams University

2. Presentation (symptoms)

3. Nasopharyngeal diseases Symptoms:
Nasal: Obstruction, discharge, bleeds, Nasal tone of voice,..
Aural: blockage, earache,..
Others: neck nodes, cranial nerves, ocular,..

4. Oropharyngeal disases Symptoms:
Swallowing problems:
1. Dysphagia
2. Nasal regurge of food
Pain:
Sore throat; may be referred to ears.
Nasal tone of voice.
Snoring.

5. Hypopharyngeal diseases Symptoms:
Dysphagia.
Laryngeal:
hoarseness, aspiration.
Neck lump:
LNs, pharyngocele.
Pain:
referred to ear.

6. Laryngeal diseases Symptoms:
Hoarseness of voice (dysphonia)
Respiratory obstruction (stridor)
Cough
Aspiration (choking)
Pain
Dysphagia
Others: Neck mass, spitting of blood,..

7. Nasality (nasal tone of voice)
Disturbed resonance.
Decreased resonance (closed nasality) by nasopharyngeal obstructing SOLs.
Resonance of non-resonating consonants (open nasality) in cleft, short, or paralyzed palate.

8. Nasal regurge of food
Escape of food (mainly fluids) into the nose during swallowing.
Palatal problem:
short, cleft, perforated, or paralyzed palate.

9. Dysphagia:
Difficulty, pain, or even sense of awareness, during any phase of deglutition.
Odynophagia (painfull swallowing).
Towards solids or fluids (or both).
Absolute dysphagia!, regurge of food!

10. Swallowing is not always an easy task!!

11. Snoring
A sound produced by vibrations of the soft palate & pharyngeal walls due to partial upper airway obstruction.
Sleep apnea: attacks of arrest of breathing due to complete upper airway obstruction during sleep.

12. Stridor
A musical (high pitched) sound produced due to marked airway obstruction at the level of the larynx or upper trachea (sometimes the pharynx).
Emergency!!!

13. Examination

14. Clinical Examination: 1. Nasopharynx
Finger palpation:
An old method.
Not to be used…
Unhuman !!!

15. Clinical Examination: 1. Nasopharynx
Mirror examination:
Needs good patient’s
cooperation.
Sometimes very
difficult.

16. Clinical Examination: 1. Nasopharynx
Flexible endoscopy:
Used for nose, pharynx & larynx.

17. Clinical Examination: 2. Oropharynx
By tongue depressor.
Flexible endoscopy.

18. Clinical Examination: 3. Larynx & hypopharynx
External examination:
Inspection (for position, swelling, deformity, movement with deglutition)
Palpation (for tenderness, deformity, laryngeal click)
Examination of other regions of the neck (specially for LNs)

19. Clinical Examination: 3. Larynx & hypopharynx
Laryngeal mirror:

20. Clinical Examination: 3. Larynx & hypopharynx
Rigid telescope

21. Clinical Examination: 3. Larynx & hypopharynx
Flexible endoscopy:
Used for nose, pharynx & larynx.

24. Investigations

25. Investigations Radiology: 1. Plain X-rays. 2. Ba swallow. 3. CT & MRI.
Endoscopy under GA (to see & take biopsy).

26. Plain X-ray lat. view for nasophx

27. Plain X-ray lat. view neck

28. Barium swallow

29. Barium swallow

30. CT & MRI

31. CT & MRI

32. Direct endoscopy

33. THANK YOU…