Laryngeal Carcinoma MCQs

Foul smelling discharge with perforation of pars flaccida of the tympanic membrane is suggestive of atticoantral CSOM. It is always managed surgically. So tympanomastoid exploration(MRM) is the correct answer. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 85, 87.

T1N0M0 glottic malignancy - Tumour limited to vocal cord(s) with normal mobility. Carcinoma of the mobile membranous vocal cord is traditionally treated with radiotherapy. Now such lesions are precisely excised with CO2 laser under microscope with the same good results . Laser excision has the advantages of lower cost, lower duration of treatment and morbidity. REF:- Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra ,8 th Edition, pg. no - 363

Carcinoma of the mobile membranous vocal cord is traditionally treated with radiotherapy. Now such lesions can be precisely excised with CO2 laser under microscope with the same good results. Laser excision has the advantages of lower cost, lower duration of treatment and morbidity. Similar T1 lesions of the supra- or infrahyoid epiglottis with or without neck nodes have been treated with CO2 laser. Cervical nodes in such cases are managed surgically with appropriate neck dissection. Endoscopic CO2 laser is getting popular at some centers where facilities of CO2 laser and expertise are available. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page Number-363.

Leukoplakia or keratosis of larynx is a premalignant epithelial hyperplasia involving the upeer surface of vocal cords. Treatment includes Stripping of vocal cords followed by histology of tissue for any malignant change. Laser vaporizer can also be used. Chronic laryngeal irritants should be eliminated. Partial laryngectomy is done for T2 stage of carcinoma larynx. Reference - Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no 354

Vertical partial laryngectomy is done for T2N0Mo glottic cancer. The growth should be limited to one side and other side should be free. Horizontal partial laryngectomy is done for T2N0M0 supraglottic cancer. The pre-requisite is the growth should be limited to supraglottis and both vocal cords are free and mobile. The lung functions should be also good REF:- Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra ,8 th Edition, pg. no - 363

Horizontal partial laryngectomy is done for T2N0M0 supraglottic cancer. The pre-requisite is the growth should be limited to supraglottis and both vocal cords are free and mobile. The lung functions should be also good. Vertical partial laryngectomy is done for T2N0Mo glottic cancer. The growth should be limited to one side and other side should be free. REF:- Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra ,8 th Edition, pg. no - 363

Transmuscular cordectomy (type III) is performed by cutting through the vocalis muscle. The resection encompasses the epithelium, lamina propria, and part of the vocalis muscle. The resection may extend from the vocal process to the anterior commissure. Reference: Diseases of Ear, Nose, AND Throat by PL Dhingra

Explanation: The patient is most likely to have sustained traumatic tympanic membrane perforation, resulting in blood clots in the ear canal. In cases of traumatic tympanic membrane perforation with blood clots, the safest initial step is to keep the ear dry and provide analgesics. Traumatic perforation of the tympanic membrane usually heals automatically. Its important to keep the ear dry to prevent infections, thus use of ear drops and syringing is best avoided. (Option B, D ruled out). Aspirating the clot, which seals the bleeding, may potentially cause further complications and is usually unnecessary, as the clot typically resolves spontaneously. (Option A ruled out) Overall, conservative management allows for natural healing of the tympanic membrane and pain relief.