"I can come by here and have a couple of polyps lasered off my vocal cords and then go straight to work."
— Daryl Collins, age 53

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Laryngeal Tumors

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 types of laryngeal tumors that can occur in the larynx.

A common benign tumor of the larynx is laryngeal papillomatosis. This condition is caused by the human papillomavirus (HPV. 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 identified strains of the HPV virus that can cause papillomatosis. These growths can lead to vocal cord damage and airway problems.

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

Causes or Contributing Factors:

There are more than 60 strains of human papillomavirus (HPV), which causes laryngeal papillomatosis. However, it is still unclear how people contract the virus.

Risks factors for cancer of the larynx include:

  • Smoking
  • Heavy alcohol consumption (especially when combined with smoking)
  • Age (laryngeal cancer is more common in people over 55)
  • Gender (men are four times more likely than women to contract the disease)
  • Race (African-Americans have a higher incidence of laryngeal cancer)
  • Exposure to materials such as asbestos or other cancer-causing environmental substances

Symptoms:

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

  • Hoarseness
  • Chronic coughing
  • Difficulty breathing
  • Sensation of a lump in the throat
  • Rough or scratchy voice
  • Difficulty or pain with swallowing
  • Ear pain
  • Voice weakness and strain

Diagnosis:

The Emory Voice Center team will ask the patient about symptoms and medical history, followed by a thorough head and neck examination. The examination likely will involve several members of the 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 for Laryngeal Papillomatosis:

Laryngeal papillomas can be removed using traditional surgery or carbon dioxide laser surgery. Since these tumors may recur, repeated surgeries are usually necessary.

Severe cases of laryngeal papillomatosis can also be treated with chemotherapy.

Treatments for Laryngeal Cancer:

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.