Laryngeal cancer physical examination: Difference between revisions

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{{Laryngeal cancer}}
{{Laryngeal cancer}}
{{CMG}}; {{AE}}{{JH}}.
{{CMG}}; {{AE}} {{OK}}, {{JH}}, {{Faizan}}


==Overview==
==Overview==
Patients with [[laryngeal carcinoma]] are usually well appearing. [[Physical examination]] of patients with [[laryngeal carcinoma]] is usually remarkable [[neck]] [[swelling]], [[hearing loss]], and [[stridor]].
==Physical Examination==
==Physical Examination==
Diagnosis is made by the doctor on the basis of a careful [[medical history]], [[physical examination]], and special investigations which may include [[Chest X-Ray]], [[Computed tomography|CT]] or [[MRI]] scans, and tissue biopsy. The examination of the larynx requires some expertise, which may require specialist referral.
[[Physical examination]] of [[patients]] with [[laryngeal carcinoma]] is usually remarkable for the following: <ref name="pmid27841116">{{cite journal |vauthors=Jones TM, De M, Foran B, Harrington K, Mortimore S |title=Laryngeal cancer: United Kingdom National Multidisciplinary guidelines |journal=J Laryngol Otol |volume=130 |issue=S2 |pages=S75–S82 |date=May 2016 |pmid=27841116 |pmc=4873912 |doi=10.1017/S0022215116000487 |url=}}</ref><ref name="pmid19368278">{{cite journal |vauthors=Jovanović MB |title=[Diagnosis of laryngeal carcinoma] |journal=Med. Pregl. |volume=61 |issue=11-12 |pages=591–5 |date=2008 |pmid=19368278 |doi= |url=}}</ref>


The [[physical exam]] includes a systematic examination of the whole patient to assess general health, to look for signs of associated conditions and metastatic disease. The neck and [[supraclavicular fossa]] are palpated to feel for cervical adenopathy, other masses, and laryngeal crepitus. The oral cavity and oropharynx are examined under direct vision. The larynx may be examined by Indirect laryngoscopy using a small angled mirror with a long handle (akin to a dentist's mirror) and a strong light. Indirect laryngoscopy can be highly effective, but requires skill and practice for consistent results. For this reason, many specialist clinics now use fibre-optic nasal endoscopy where a thin and flexible [[endoscope]], inserted through the nostril, is used to clearly visualise the entire pharynx and larynx. Nasal endoscopy is a quick and easy procedure, performed in clinic. Local anaesthetic spray may be used.
===Appearance of the Patient===
 
*Patients with [[laryngeal carcinoma]] are usually well appearing
Painful [[paronychia]] in association with a scaly, erythematous, keratotic rash (papules and plaques) of the ears, nose, fingers, and toes, may be indicative of [[acrokeratosis paraneoplastica]], which is associated with [[squamous cell carcinoma]] of the [[larynx]].
===Ears===
 
*There may be diminished [[hearing]]
===Gallery===
===Throat===
 
*The [[throat]] may be [[erythematous]]
====Neck====
===Neck===
 
*[[Neck]] [[swelling]] may be present
<gallery>
*Swollen [[lymph nodes]] may be present
 
*[[Laryngeal]] [[crepitus]] may be present
Image: Metastatic_laryngeal_cell_carcinoma_01.jpg| Metastatic laryngeal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=289>
===Lungs===
 
*[[Stridor]] may be present due to partial [[airway obstruction]]
Image: Metastatic_laryngeal_cell_carcinoma_02.jpg| Metastatic laryngeal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=289>
===Extremities===
 
With [[squamous cell carcinoma]] of the [[larynx]], painful [[paronychia]] might be present
</gallery>


==References==
==References==
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[[Category:Otolaryngology]]

Latest revision as of 21:54, 10 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2], Jesus Rosario Hernandez, M.D. [3], Faizan Sheraz, M.D. [4]

Overview

Patients with laryngeal carcinoma are usually well appearing. Physical examination of patients with laryngeal carcinoma is usually remarkable neck swelling, hearing loss, and stridor.

Physical Examination

Physical examination of patients with laryngeal carcinoma is usually remarkable for the following: [1][2]

Appearance of the Patient

Ears

Throat

Neck

Lungs

Extremities

With squamous cell carcinoma of the larynx, painful paronychia might be present

References

  1. Jones TM, De M, Foran B, Harrington K, Mortimore S (May 2016). "Laryngeal cancer: United Kingdom National Multidisciplinary guidelines". J Laryngol Otol. 130 (S2): S75–S82. doi:10.1017/S0022215116000487. PMC 4873912. PMID 27841116.
  2. Jovanović MB (2008). "[Diagnosis of laryngeal carcinoma]". Med. Pregl. 61 (11–12): 591–5. PMID 19368278.


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