Anatomy of the Condition:
The larynx or voice box begins at the back of the throat and extends down, carrying air from the nose and mouth to the trachea and then into the lungs.

There are several varieties of tumors that can occur in the larynx.
A common benign tumor which arises in the larynx is laryngeal papillomatosis.  This condition is caused by the Human Papilloma Virus.  Between 60 and 80 percent of all cases of laryngeal papillomatosis are found in children, although the causes and reasons for spread of the virus are largely unknown. There are over 60 strains of the virus identified that can cause papillomatosis.

These growths can lead to voice and even airway problems.

A variety of malignant tumors can also arise in the larynx.

Causes or Contributing Factors
There are more than 60 strains of the human papilloma virus, (HPV), which causes laryngeal papillomatosis.  However, medical science is still unclear about how people contact the virus. 

Risks factors for cancer of the larynx include:

• Smoking
• Heavy Alcohol Consumption (especially when combined with smoking)
• Over age 55
• Men are four times as likely to contract the disease as women
• African-Americans have a higher incidence of laryngeal cancer
• Exposure to materials such as asbestos or other cancer causing environmental substances

Symptoms:
Symptoms for all forms of laryngeal tumors can manifest with similar symptoms. Patients who experience chronic or persistent bouts with the following symptoms should see their physician for a medical diagnosis.  These include:

• Hoarseness
• Chronic Coughing
• Difficulty Breathing
• The sensation of a lump in the throat
• Rough or scratchy voice
• Difficulty or pain with swallowing
• Ear pain
• Voice weakness and strain

Diagnosis:
The voice team will ask the patient about symptoms and their medical history, followed by a thorough head and neck examination. The examination likely will involve several members of the voice team to assess vocal quality, efficiency, and proper speaking technique.

Laryngeal videostroboscopy may be required.  This is a procedure using a flexible and/or rigid endoscope coupled to a video monitor and a stroboscopic light source to allow for detailed visual evaluation of laryngeal function and vibration.

A direct laryngoscopy or microlaryngoscopy may be required.  It is a procedure conducted under general anesthesia which allows the physician to examine the vocal folds of the larynx with high magnification.  During the procedure, the physician may obtain tissue samples for biopsy or remove a mass or tumor.

Treatments:

Non-Operative

• Severe cases of laryngeal papillomatosis can be treated with chemotherapy. However, surgical therapy is the most common treatment.
• The treatment of laryngeal cancer will depend on the type of malignancy and the stage at which the condition is diagnosed.  Surgery, chemotherapy, and/or radiation therapy may be required.  Patients with laryngeal malignancies are presented at the multidisciplinary Emory head and neck cancer tumor board to optimize and individualize treatment.

Operative

• Laryngeal papillomas can be removed with the use of traditional
   surgery or with the assistance of the carbon dioxide laser surgery. Since these 
   tumors may reoccur, repeated surgeries are usually necessary.
• The treatment of laryngeal cancer will depend on the type of malignancy and the stage at which the condition is diagnosed.  Surgery, chemotherapy, and/or radiation therapy may be required.  Patients with laryngeal malignancies are presented at the multidisciplinary Emory head and neck cancer tumor board to optimize and individualize treatment.