Anatomy and Physiology of Larynx MCQs

Ans. is 'b' i.e., C6 [Ref BDC 5I'Ve Vol. III, p. 237]

Juvenile papillomas are premalignant. All papillomas should be examined histopathologically to exclude any dysplastic features or malignant transformation. They are caused by HPV-6,11. The infection is transmitted from mother to child at the time of birth. CO2 laser is the treatment of choice. Recurrences are common after surgery. Reference - Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no 356

Leukoplakia or keratosis larynx Localized form of epithelial hyperplasia involving upper surface of one or both vocal cords. White plaque or warty growth on the cord without affecting its mobility. Precancerous condition Treatment is stripping of vocal cords followed by histology of tissue for any malignant change. Chronic laryngeal irritants should be eliminated. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no 354

Larynx has three unpaired and three paired cartilages. Unpaired: Thyroid, cricoid and epiglottis. Paired: Arytenoid, corniculate and cuneiform Reference – Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra , 8 th Edition, pg. no – 331

Infant's larynx is small and conical. The diameter of cricoid cartilage is smaller than the size of glottis, making subglottis the narrowest part . Paediatric endotracheal tube selection depends on this. In adults, glottis is narrowest part . Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no 335 Scott Brown's Otolaryngology, Head and Neck Surgery - 8 th edition - Volume 3 - Page number - 1081

Management of Juvenile papilloma of larynx - Microlaryngoscopy and CO2laser excision avoiding injury to vocal ligament. Recurrence is common and procedure needs to be repeated several times. In the absence of CO2 laser - tumour removed under microscope with cup forceps or a debrider. Medical therapies - can be used as adjuvants. Interferon alpha-2a has shown promising results but has several side effects including fever, chills, myalgia, arthralgia, headache, loss of weight and suppression of bone marrow. 13-cis-retinoic acid has also been used. This too has several side effects. REF: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no 356

Explanation: The adult laryngeal airway is divided into three regions: supraglottis, glottis, and subglottis . The glottis , which includes the true vocal cords and the space between them, is the narrowest part of the adult airway. In contrast, the pediatric airway has its narrowest point at the cricoid cartilage (subglottis). Knowledge of the narrowest airway region is crucial for airway management, endotracheal intubation, and recognizing potential sites of obstruction. Explanation of Other Options: Supraglottis (Option A): Includes epiglottis, arytenoids, false cords, and ventricles; wider than the glottis. Subglottis (Option C): Area below the vocal cords to the cricoid; narrowest in children. Trachea (Option D): Continues below the subglottis; larger than glottis in adults. Reference: https://pubmed.ncbi.nlm.nih.gov/33232069/

Lupus larynx Involves the anterior part of the larynx Epiglottis is the most common site. Painless condition. Associated with lupus of nose and larynx. The remaining points are true for tuberculosis of larynx. (OPTIONS a,c,d) TB larynx is a painful disease associated with pulmonary TB. The earliest lesions form in the posterior part of larynx with turban epiglottis occurring in the later part. Weakness of voice and painful phonation are the classical symptoms of TB larynx. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra ,8 th Edition, pg. no – 343