Medical and Surgical Treatment Flashcards

What is the mainstay of treatment for recurrent respiratory papillomatosis?

Answer: Repeated surgical debulking with preservation of normal tissue

RRP is managed with repeated microdebrider or laser debulking, and adjuvants are added for aggressive disease.

A patient has permanent unilateral vocal fold paralysis and a breathy voice from glottic insufficiency. Which procedure gives durable medialization?

Answer: Type I (medialization) thyroplasty

Medialization thyroplasty places an implant through a thyroid cartilage window to push the paralyzed fold toward the midline.

A patient with bilateral vocal fold paralysis in the paramedian position has stridor. Which endoscopic procedure enlarges the airway?

Answer: Posterior transverse cordotomy

Posterior cordotomy widens the posterior glottis to relieve airway obstruction, at some cost to voice.

Which treatment options give similar oncologic control for T1a glottic squamous cell carcinoma?

Answer: Transoral laser microsurgery or radiation therapy

Early glottic cancer has high cure rates with either single-modality transoral laser surgery or radiation.

A patient has trismus, uvular deviation, and a peritonsillar abscess. What is the initial management?

Answer: Needle aspiration or incision and drainage plus antibiotics

Drainage by aspiration or incision, combined with antibiotics, is the standard first-line treatment for peritonsillar abscess.

What is the usual empiric medical regimen for suspected laryngopharyngeal reflux?

Answer: Twice-daily proton pump inhibitor for 2-3 months

LPR is usually treated empirically with twice-daily PPI for at least 8-12 weeks, along with behavioral changes.

What is a common minimally invasive surgical treatment for a symptomatic Zenker diverticulum?

Answer: Endoscopic stapler-assisted diverticulotomy

Endoscopic diverticulotomy divides the common wall and the cricopharyngeus muscle, removing the pouch and the obstruction.