Benign tumors of the larynx are tumor formations that are localized in the larynx. Characterized by the absence of metastasis or ulceration, slow non-invasive growth. Quite often, benign tumors of the larynx are asymptomatic. Sometimes they are manifested by hoarseness and hoarseness of voice, respiratory disorders, cough. The significant size of the tumor causes the occurrence of asphyxia and even aphonia. An otolaryngologist is responsible for the diagnosis of benign tumors of the larynx, who conducts an endoscopic biopsy, histological examination and laryngoscopy. The most effective surgical method is considered to be the treatment of benign tumors of the larynx. The characteristics of the course of treatment are influenced by the nature, type and growth of the tumor.
The content of the article:
Types of benign tumors of the larynx
Causes of benign laryngeal tumors
Symptoms of benign laryngeal tumors
Diagnosis of benign laryngeal tumors
Treatment of benign tumors of the larynx
Prognosis of benign laryngeal tumors
Benign tumors of the larynx
Benign tumors of the larynx are based on various tissue structures — a vessel, cartilaginous and connective tissue, glandular components of the mucosa, nerve endings and trunks. They may appear during the patient’s lifetime or have an innate character. In otolaryngology, angioma, fibroma, papilloma and polyps are the most common among all benign tumors of the larynx. Lipoma, chondroma, cyst, laryngeal neurofibroma and neurinoma are much less often diagnosed. Benign tumors of the larynx are much more common in men than in women.
Types of benign tumors of the larynx
Fibroids are benign tumors of the larynx that have a connective tissue nature of origin. In most cases, this is a single spherical formation that is localized on the upper surface or on the free edge of the vocal fold. The size of the fibroma ranges from 0.5-1.5 cm. Laryngeal fibroids have a smooth surface, gray color and can be on the leg. A large number of blood vessels in the fibroma structure can change its color to red (angiofibroma). These benign tumors of the larynx are clinically manifested by various voice changes. This type of tumor can cause breathing problems if it reaches a large size.
Laryngeal polyps are called a separate type of fibroids, the structure of which, in addition to connective tissue fibers, also consists of a large amount of fluid and cellular elements. These benign tumors of the larynx have a wide base or a thick stem and can reach the size of a pea. In addition, polyps may have a less dense consistency than fibroids. These formations are localized in the anterior part of one of the vocal folds. The only manifestation of the polyp, as a rule, is hoarseness of the voice. Coughing or changes in breathing are usually not observed.
Angiomas are benign tumors of the larynx that are of vascular origin. Angiomas are single formations and are congenital in nature. Tumors from blood vessels (hemangiomas) bleed heavily when injured, can grow into surrounding tissues, have a red color. Tumors from lymphatic vessels (lymphangiomas) are not prone to grow and have a yellowish color.
Laryngeal papillomas are a special type of benign tumors. In adults, laryngeal papillomas are single or multiple (less often) dense outgrowths with a wide mushroom-shaped base. They have a pinkish or whitish color, can be dark red with intensive blood supply. Papilloma can affect the mucous membrane of the trachea, but this is observed only in some cases. Juvenile papillomas are observed in children. These formations most often appear in the period from 1 to 5 years. During puberty of a child, juvenile papillomas are prone to spontaneous disappearance. Multiple papillomas develop more often in childhood, they occupy entire areas of the mucous membrane. Otherwise, this phenomenon is called papillomatosis. Such benign tumors of the larynx outwardly resemble cauliflower. Usually the lesion is localized on the vocal folds. However, in some cases, the process can extend to the subcladal region, epiglottis, trachea, scooped-out folds. Laryngeal papillomatosis is clinically manifested by hoarseness passing into aphonia. Chronic laryngeal stenosis occurs if there is a significant growth of the tumor.
Chondromes are benign tumors of the larynx of a dense structure, originate from cartilage tissue. After some time, malignant degeneration may occur with the subsequent development of chondrosarcoma.
Laryngeal cysts develop from germinal gill slits, in turn, the occurrence of which is due to disorders of embryogenesis. Retention cysts are diagnosed in children. These cysts are formed from the glands of the mucous membrane of the larynx. Laryngeal cysts practically do not cause any symptoms, since they are rarely large.
Lipomas are benign tumors of the larynx of ovoid shape, yellow color, often having a leg. Laryngeal lipomas, as well as lipomas of the second localization, consist of adipose tissue.
The above-mentioned benign tumors of the larynx require surgical intervention, since in the future they can harm health.
Causes of benign laryngeal tumors
Congenital benign tumors of the larynx arise due to the effects of various teratogenic factors and genetic predisposition on the fetus. Teratogenic factors are infectious diseases of the mother during pregnancy (measles, rubella, chlamydia, viral hepatitis, mycoplasmosis, HIV, syphilis), the reception of embryotoxic medications by a pregnant woman, radiation exposure, and the like.
The main causes of the appearance of benign tumors of the larynx of an acquired nature can be called some viral diseases (herpetic and adenovirus infection, measles, influenza, HPV), prolonged exposure to irritating substances (inhalation of tobacco smoke, fine dust, work in a smoky room), chronic inflammatory diseases (tonsillitis, adenoids, chronic pharyngitis and laryngitis), severe vocal loads, changes in the work of the endocrine system.
Symptoms of benign laryngeal tumors
In patients with benign tumors of the larynx, the voice changes noticeably. He becomes hoarse or hoarse. Benign tumors of the larynx with long legs are characterized by frequent coughing and changes in the voice. Complete absence of voice (aphonia) can be observed when the tumor is localized in the area of the vocal cord and prevents its closure. Large benign tumors of the larynx cause difficulty in breathing. Sometimes they become a prerequisite for asphyxia, especially a small child can suffer from this.
Diagnosis of benign laryngeal tumors
Small benign tumors of the larynx, do not prevent the closure of the vocal cords, are asymptomatic. In most cases, an otolaryngologist discovers them accidentally when examining a patient for a disease of another origin.
Benign tumors of the larynx clinically have fairly typical symptoms, thanks to which they can be diagnosed. At the same time, the doctor should differentiate benign tumors from malignant processes, scleromas and foreign bodies that may have similar symptoms.
To confirm the diagnosis of “benign laryngeal tumor”, a microlaryngoscopy is performed, which allows a more detailed examination of the appearance of the tumor. It is possible to determine the exact type of formation after conducting its histological examination. Histology of a benign laryngeal tumor is performed after its removal. Sometimes an endoscopic biopsy of the formation is additionally prescribed. The study of the degree of mobility and closure of the vocal cords, voice function is carried out using stroboscopy, phonetography, electroglottography and determining the time of maximum phonation. The diagnosis of the prevalence of benign tumors of the larynx is carried out using ultrasound, MRI or CT, X-ray of the skull. At this stage, it is important to determine the area of the spread of education, without this it will not be possible to start treatment.
Treatment of benign tumors of the larynx
Benign tumors of the larynx due to the likelihood of malignancy and due to the development of complications (respiratory and vocal disorders) are subject to surgical removal. Endoscopic removal with laryngeal forceps or a special loop is performed with small sizes of polyps and fibroids. Small laryngeal cysts can be excised along with their shell. Large laryngeal cysts are punctured before removal and all the fluid is extracted from them. To avoid relapses of the cyst, cryoprocessing of the base is performed after the operation.
The method of removing benign tumors of the larynx directly depends on the nature of the growth and prevalence of the tumor. Local hemangiomas, which are characterized by exophytic growth, are excised, anti-relapse treatment is carried out on the affected area by cryotherapy, laser irradiation or diathermocoagulation. Sclerosing or occlusion of feeding vessels is used for endophytic growth of benign tumors and their widespread nature.
It is most difficult to treat laryngeal papillomatosis, since it is necessary to remove those areas of the mucosa that have changed. It is impossible to imagine such an operation without a surgical microscope, the only way to leave healthy tissue or a certain vessel intact.
Limited areas of papillomatosis are removed by laser or cryodestruction, diathermocoagulation. Surgical intervention for the prevention of relapses should be accompanied by immunomodulatory and antiviral therapy. Children with papillomatosis are self-vaccinated in order to increase immunity. If necessary, a second course of treatment can be carried out. The recurrence of papillomatosis and a significant increase in papilloma growths after the operation requires a special course of chemotherapy. Otherwise, a benign tumor will grow into a malignant one, which is much more difficult to fight.
Prognosis of benign laryngeal tumors
Timely treatment of benign tumors of the larynx gives a favorable prognosis for recovery. However, there is a risk of frequent recurrence of some types of tumors. The most unfavorable in this sense of all benign tumors of the larynx is laryngeal papillomatosis, especially for young children. In adults, such relapses occur very rarely. However, after surgery, complete restoration of the voice does not always occur.
