[20,21] Nasal obstruction and sepsis may be acting as adjuvant etiological factors and it has been suggested that in nasal obstruction, the inspired air is deviated from the humidifying action of nasal mucosa and may exert a negative influence on the epithelium of the true vocal cords. Similarly, the cords can be exposed to the toxic effects of mucopus originating in the paranasal sinuses.
Surgical treatment of the benign lesions of larynx is necessary not only for the histological confirmation of the clinical diagnosis but also for reestablishing the mechanism of normal phonation, which is altered by the changes in the mass, flexibility, elasticity, resistance, or morbidity of the true vocal cord. [22,11,19] Surgical treatment was the treatment of choice in the majority of the cases studied (94%), and voice rest and rehabilitation sufficed in the remaining 6% cases of benign lesions of the larynx.
Manipulation of the epithelium during microlaryngoscopy may provide information about the fixation of the upper layers of the true vocal cord
. Knowledge about the tactile feedback may considerably improve the accuracy.
High-resolution computed tomography was obtained revealing a 4.2 cm cranio-caudal soft tissue mass in the larynx extending from the epiglottis down through the level of the false vocal cords, vestibule, and true vocal cords
. Anterior commissure involvement was also noted with an ill-defined thyroid cartilage, suspicious for invasion of the inner cortex.
Even though life threatening complication rarely occur in these lesions, there were cases of airway compromise and even death reported due to large vocal cord polyp.6,7 When the polyps appear at the underside of the true vocal cord
, the hanging lesions would flop and follow the rhythm of respiration.
The true vocal cords appear pearly white in colour and contains the vocal ligaments, which in turn are the thickened medial edges of the thyro-aryteniod muscles.
SUBGLOTTIS: The subgottis begins superiorly from 1cm below the free margin of the true vocal cord and extends inferiorly to the lower border of the cricoid cartilage.
Basement membrane is visible separating the surface epithelium from the underlying connective tissue of lamina propria (Fig-1) The epithelium lining the true vocal cords appear to be similar to the one lining the entire ventricular cavity.
In the true vocal cords, diminished height of the stratified squamous epithelium is observed as a result of desquamation Goblet cells are more in number in the lower part of the laryngeal mucosa as compared to the previous group (Fig.
The ventricles and the false and true vocal cords
are the most common sites for localized amyloidosis in the respiratory tree.