in proximity to it. With partial laryngectomy the
airway and often part of the vocal structures
remain intact, so breathing and speech are normal
after recovery, though the quality and volume of
the voice may change.
See also CANCER RISK FACTORS; CANCER TREATMENT
OPTIONS AND DECISIONS; ELECTROLARYNX; HEALING;
SMOKING AND CANCER; SMOKING AND HEALTH; SURGERY
BENEFIT AND RISK ASSESSMENT.
laryngitis Irritation or INFLAMMATIONof the lar-
ynx (voice box) that results in hoarseness or loss
of voice. Most laryngitis is viral, though may
accompany or follow a bacterial INFECTIONsuch as
STREP THROAT. Laryngitis is also common in people
who strain their voices through loud singing,
yelling, and extended talking, and in people who
smoke or who work or live in environments that
are smoky. Resting the voice by speaking softly
(though not whispering as it further stresses the
tissues of the larynx) and sucking on hard candy
or COUGHdrops help soothe the irritated tissues. A
cool-mist humidifier, especially when sleeping,
helps reduce irritation. Most laryngitis goes away
within 10 to 14 days and does not need medical
treatment. Bacterial laryngitis requires treatment
with an appropriateANTIBIOTIC MEDICATIONS.
A doctor should evaluate laryngitis when:
- hoarseness/discomfort last longer than 14 days
- an accompanying cough produces yellow or
green sputum - FEVERis greater than 101ºF
Frequent or extended laryngitis might indicate
the presence of VOCAL CORD NODULE, VOCAL CORD
POLYP, or laryngeal CANCER.
See also BOGART-BACALL SYNDROME; COLDS;
EPIGLOTTITIS; PHARYNGITIS; SMOKING AND HEALTH; TON-
SILLITIS; VIRUS.
laryngocele An air-filled bulge (herniation) that
develops within the tissues of the larynx (voice
box), often among the folds of the VOCAL CORDS.
Laryngocele may be present at birth as a CONGENITAL
ANOMALYor develop later in life, often as a conse-
quence of persistent pressure against the structures
of the THROAT. A congenital laryngocele may not
cause symptoms until environmental stressors that
create increased laryngeal pressure cause it to
enlarge. Musicians who play wind instruments are
particularly vulnerable to laryngoceles, as are peo-
ple with OBSTRUCTIVE SLEEP APNEA. Occasionally a
laryngeal tumor causes a laryngocele.
Hoarseness, a feeling that there is something
caught in the throat, dry COUGH, and a soft lump vis-
ible on the external throat are among the most
common symptoms. A large laryngocele can cause
stridor (a high-pitched noise with inhalation) and
difficulty swallowing. The diagnostic path typically
includes COMPUTED TOMOGRAPHY(CT) SCANor MAG-
NETIC RESONANCE IMAGING(MRI) of the throat and
laryngoscopy (examining the inside of the throat
through a lighted, flexible scope). Because a laryn-
gocele presents a prime opportunity to trap BACTE-
RIAthat cause INFECTIONas well as the potential to
interfere with BREATHINGand swallowing, the treat-
ment of choice is an OPERATIONthrough an incision
in the neck to close or remove the laryngocele.
See also BREATH SOUNDS; ENDOSCOPY; SWALLOWING
DISORDERS.leukoplakia Precancerous patches, or lesions,
inside the MOUTH. The patches are light-colored
and most commonly form on the tongue and
insides of the cheeks. Irritation to these tissues
over time, such as from all forms of tobacco use
and poorly fitting dentures or dental bridges,
causes leukoplakia to develop. In a type of leuko-
plakia specific to people with HIV or AIDS, hairy
leukoplakia, the patches look like white fuzz.
Hairy leukoplakia often is one of the earliest signs
of HIV INFECTION. Leukoplakia may also affect the
VULVAin women. Biopsy to examine the cells of
the patches confirms the diagnosis. In some peo-
ple, removing the source of the irritation causes
the leukoplakia to go away. Often doctors prefer
to remove the lesions surgically, which generally is
an office procedure with local ANESTHESIA. When
the irritation continues, or in the presence of
HIV/AIDS, leukoplakia may return.
See also ORAL HYGIENE; SMOKING AND CANCER;
SMOKING AND HEALTH; TOBACCO USE OTHER THAN
SMOKING.32 The Ear, Nose, Mouth and Throat