T = primary site of Tumor

N = inovlement of lymph Nodes

M = Metastasis

laryngectomy = surgery to remove larynx

- Total laryngectomy: entire larynx removed

- Hemilaryngectomy: only diseased part removed

- Total w/ Radical Neck Resection: lymphatic system in neck is also removed

(Note: Laryngectomee = the person who has had larynx removed)

- External devices: artificial/electrolarynx

- Esophageal Speech: Injection Method; Inhalation Method

- Surgical Modifications/Implanted Devices: Blom-Singer Tracheoesophageal Puncture (TEP)

Surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (microsurgery of the vocal folds done through an endoscope), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection into the larynx of medications as well as synthetic and organic biologic substances), and reinnervation (restoration of the nerve supply) of the larynx. The term "phonosurgery" was coined in the early 1960s.

Irritable Larynx Syndrome

- hyperkinetic larnyngeal dysfunction resulting from a variety of specific causes in response to a definitive triggering stimulus

(Note: it is NOT I.L.S. if there is an organic laryngeal or neurological disease)

- loss of voice, esp. due to an organic or functional disturbance of the vocal organs

- Unilateral VF paralysis may cause if paralyzed fold is too far from midline & healthy fold cannot make contact to acheive closure; same idea of Bilateral VF paralysis (b/c of wide open glottis)

"Double Voice"

- 2 different pitches heard simultaneously

- polyps can cause b/c healthy fold vibrates at a different rate than the fold with the polyp

• a focal laryngeal dystonia
• believed to have neurogenic causes with possible emotional sid effects
• thought to involve brainstem dysfunction

AbDuctor SMD:  created by intermittent involuntary, fleeting vocal fold abduction when the patient tries to phonate

ADDuctor SMD:  (most common) characterized by overpressure due to prolonged overadduction or tight closure of the vocal folds.  Voice may sound choked and strangled

Treatment:

• CO2 Laser surgery
• Recurrent laryngeal nerve (RLN) resection
• BOTOX injection
• Voice therapy