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Left anterior saccular cyst (Lab).
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Small mucus retention cyst and capillary ectasia,
left vocal fold. Note yellowish color and origin from
just below free margin, as well as normal right vocal
fold (Lab).
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Left mucus retention cyst with right nodular reaction
(OR).
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Right epidermoid cyst during breathing (Lab). Note
whitish sphere not as prominent due to thicker overlying
mucosa, vascularity and mucus, suggesting concurrent
acid reflux.
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Same patient, during phonation, showing mismatch.
In addition, right side very stiff and non-vibratile
(Lab).
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Open epidermoid cyst. Note mottled appearance, white
color of cyst contents, bilaterality, and small divot
at arrow showing point of leakage but not complete emptying
of cyst contents (OR).
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Faint line of glottic sulcus at arrow. Essentially
the result of a cyst that has completely emptied of
its contents (OR).
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Same patient, while instrument holds one lip of
the sulcus, splaying it open to reveal the empty “pocket”
(OR).
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Mucosal bridge, left vocal fold (OR).
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Glottic furrow (vergeture), breathing vocal fold
position, resembling a furrow in a recently-plowed field
(Lab).
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Same patient during phonation. Such patients may
have a lot of bowing as a concomitant finding, but the
two edges of the furrow are seen on each fold, at arrows
(Lab).
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Bilateral moderate-sized nodular swellings. Left
larger than right; whitish discoloration left is mucus
(Lab).
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Diffuse resolving hemorrhage (bruise) right vocal
fold and bilateral moderate nodular swellings. White
material is mucus that goes away with throat clearing—suggesting
acid reflux (Lab).
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Same patient in open, breathing position of folds.
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Large hemorrhagic polyp right fold, with large
polypoid nodule and vascularity, left fold, during breathing
(Lab).
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Same patient during phonation, showing now faint
bruise anterior part of left-sided lesion (Lab).
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Vascular prominence (capillary ectasia) (Lab).
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Laryngitis sicca, with crusting of dry, green mucus
especially undersurface of the folds. Though a rare
long-term complication, may be seen after laryngeal
irradiation for cancer (Lab).
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Same patient, from slightly higher view (Lab).
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Candida infection of the vocal folds, often caused
by inhalation of aerosolized steroid for asthma. Usually
seen with higher strengths of medication and frequent
dosing; also more likely if antibiotics used at same
time (Lab). This can look like mucus accumulation, but
does not move or clear away even with aggressive throat-clearing.
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Same patient, after treatment with antifungal agent.
Note residual haziness (Lab).
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Ulcerative supraglottitis. This form is an atypical,
extremely painful, but less fulminant case, possibly
viral in origin (Lab).
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Contact granuloma, posterior left vocal fold, breathing
position (Lab).
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Same patient, as vocal folds begin to come together
for phonation, showing right fold fitting into the groove
between the two lobes of the granuloma (Lab).
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Papillomas in patient with recurrent respiratory
papillomatosis (RRP) involving subglottis and very high
trachea (Lab).
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Cancer involving the supraglottic larynx. The airway
(dark area) and vocal fold are partially obscured by
out-growing tumor (Lab).
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Biopsy of lesion involving the petiole (low laryngeal
surface of epiglottis). The pathology report revealed
squamous cell carcinoma, usually caused by smoking (Lab).
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Early right vocal fold carcinoma, operative view
(OR).
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Same lesion, at the start of laser removal (OR).
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Same larynx, after removal is complete. With healing
over the next several months, the deficit “fills
in” and voice result is often surprisingly good
(OR).
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Large glottic web comprising most of the vocal
folds, after removal of large smoker’s polyps
and surgeon-directed voice rest 21 days (Lab).
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Severe injury from prolonged intubation. There
are divots at posterior 1/3 of each vocal fold. Thin
dark line demonstrates expected continuation of fold,
to accentuate the divot (small black arrow). Subglottic
stenosis seen faintly in the receding darkness below
the folds (OR).
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Intubation injury at posterior commissure. Note
that the posterior portion of each fold has a divot
or “cookie bite” where the breathing tube
created pressure necrosis (Lab).
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Posterior commissure synechiae after prolonged
intubation. The posterior part of the vocal folds are
tethered together, preventing full opening during breathing
(OR).
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Subglottic and high tracheal stenosis, inflammatory,
idiopathic (Lab).
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Same patient, a few days after dilation and steroid
injection (Lab).
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Tracheal stenosis seen below the vocal folds in the
high trachea. This may be caused rarely by injury from
long-term breathing tube, tracheotomy, blunt trauma,
or other influences (Lab).
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View during operative (OR) esophagoscopy, as labeled.
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