Tracheoesophageal Prosthesis (TEP Speech)

Total laryngectomy is a surgical procedure, most commonly done in cancers of the larynx (voice box). In this procedure, the entire voice box is taken off and a permanent hole (tracheostomy/stoma) is created in the neck, through which the patient respires for his entire life. The indications, contraindications, surgical steps of laryngectomy are discussed separately […]

Temporal bone cancer staging systems

Staging of cancers is essential for patient counselling, treatment planning, predict treatment outcome and survival. Most commonly followed staging system for head and neck malignancies is the Tumor, Node, Metastasis (TNM staging system) by the American Joint Committee on Cancer (AJCC). Because of the relative rarity of temporal bone cancers, a universally accepted temporal bone […]

Laryngopharyngeal Reflux (LPR) scoring systems

Laryngopharyngeal reflux (LPR) can be defined as chronic irritation of larynx caused by the abnormal retrograde flow of gastric contents into the upper airway, mostly due to upper esophageal sphincter dysfunction. Studies have found that upto 50% of laryngeal complaints that present in the otolaryngeal clinics are associated with LPR. LPR is suspected in cases […]

Does my child need tonsillectomy? – Indications for pediatric tonsillectomy

Tonsillectomy is a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is the second-most common ambulatory surgical procedure (first being myringotomy with insertion of tubes) performed on children in the United States. In the […]

Laryngeal Exposure (Opening) Scores

Direct laryngoscopy is a routine procedure conducted to expose the larynx (voice box), to access and treat disorders causing voice dysfunction. Usually, the laryngoscope is placed through the mouth and the larynx is exposed under general anesthesia without difficulty. Laryngeal surgeries with help of an operating microscope (Microlaryngoscopy / MLS) is then conducted to remove […]

TNM Staging of Nasopharyngeal Carcinoma (AJCC 8)

Nasopharynx is an air-containing cavity that occupies the uppermost extent of the aerodigestive tract, at the back of the nose which connects the nose to the mouth. Detailed anatomy and physiology of nasopharynx is out of scope of this article and is discussed separately. Malignancies arising in nasopharynx / nasopharyngeal carcinoma (NPC) have different natural behavior […]

Anatomy and Physiology of Nasopharynx

Nasopharynx is an air-containing cavity at the back of the nose, which occupies the uppermost extent of the aerodigestive tract. It’s like a small cuboidal box about two to three centimeters front to back and about three to four centimeters top to bottom and side to side. The cavity is lined by pseudo stratified ciliated […]

TNM Staging of Oropharyngeal Cancer – Updates in AJCC 8th Edition

The recently released 8th edition of the American Joint Committee on Cancer (AJCC) Staging Manual, Head and Neck Section, introduces significant modifications from the prior 7th edition. In the head and neck domain, the most significant update creates a separate staging algorithm for high-risk human papillomavirus (HPV)-associated cancer of the oropharynx, distinguishing it from oropharyngeal cancer (OPC) […]

Indications and Contraindications for total laryngectomy

Total laryngectomy is a surgical procedure mostly done for malignancies involving the larynx. In this surgery, the entire larynx (voice box) is removed by resecting the trachea and bringing out the lower stump as a respiratory opening in the anterior part of the neck (permanent tracheostomy) and thereby closing off the air passages to the […]

Laryngomalacia – clinical features, surgical and medical management

Laryngomalacia also called as “discoordinate pharyngo-laryngomalacia” is the most common congenital lesion of larynx (60-70%) and is the most common cause of congenital stridor in neonates and infants. The condition is characterized by partial or complete obstruction of supraglottic laryngeal structures on inspiration because of excess mucosa, abnormal and/or reduced laryngeal tone. The term laryngomalacia […]