DICTIONARY

Barrett’s

A condition in which the mucosa of the esophagus is replaced by tissue lining the stomach and is associated with acid reflux. A small portion of patients with Barrett’s esophagus may develop adenocarcinoma of the larynx. Barrett’s esophagus may be identified on esophagoscopy.

Base of tongue

Back porition of the tongue which is part of the oropharynx.

Benign

Non-cancerous growth – in the throat this may mean, amongst many other entities, papilloma

Bevacizumab

A chemotherapeutic agent which may be used for managent of papilloma.

Biopsy

To take a small piece of for purposes of diagnosis.

Botox

Nickname for botulinum toxin

Botulinum toxin

A drug which prevents muscle contraction. In the larynx used commonly for management of spasmodic dysphonia

Bronchoscopy

Examination of the trachea and bronchi of the lung using an endoscope. This can be performed with the patient asleep or awake.

Cancer

Uncontrolled growth of cells, which can spread to other parts of the body. Cancer is a malignant process.

Candida

Fungus that can cause hoarseness when on the larynx. Associated with steroid inhaler use.

Carbon dioxide laser

Laser which targets water molecules preferentially and used in management of many diseases, from papilloma to cancer

Carcinoma

Cancer origination from epithelial cells. Squamous cell cancer of the larynx, throat, and oral cavity is a carcinoma.

Carcinoma in situ

The development of cancerous cells which are not invasive. In the larynx carcinoma-in-situ might be management with excision, laser, or even radiation.

Cidofivir

Antiviral medication that may be used in treatement of papillomatosis

Cordectomy

Cutting of the vocal fold, performed in cases of vocal fold immobility as a means to enlarge the airway and improve breathing

Cordotomy

Removal fo the vocal fold, performed in cancer operations.

Cranial Nerve

The most common nerves of the head and neck. There are 12 cranial nerves, and the most important in the throat is probably cranial nerve 10, the vagus nerve.

Cricopharyngeal Dysfunction

Abnormal and excessive contractions of the cricopharyngeus muscle which may cause symptoms of dypshagia and globus.

Cricopharyngeal myotomy

Cutting of the cricopharyngeus muscle, performed for management of Zenker’s diverticulum and cricopharyngeal dysfunction. This surgery can be performed through the mouth or through an incision on the neck.

Cricopharyngeus

A muscle located at the top of the esophagus which relaxes to allow food to pass from the throat to the esophagus.

Cricothyroid Muscle

Chief pitching changing muscle of the larynx, or voice box.

Cricothyrotomy

Incision made through the skin into the airway, often in times of emergency.

CT

CT is a radiolgoic test which provides pictures of a person’s body. In the throat it may be used for evaluation of cancer and lymph nodes.

Cymetra

Product used in vocal fold augmentation by some surgeons. Cymmetra is micronized cadaveric human dermis.

Cyst

A fluid filled sac, which, when present on the vocal fold may cause hoarseness.

Dilation

Widen or enlarge an opening. Performed in management of trachea, esophageal, and subglottic stenosis.

Diverticulum

Pouch – Zenker’s diverticulum is pouch at the back of the throat, although a diverticulum can be anywhere in the esophagus.

Dysphagia

Difficulty swallowing

Dystonia

Involuntary muscle contraction. Spasmodic dysphonia is a type of laryngeal dystonia.

Ectasia

Dilation of a blood vessel of a vocal fold. This may contribute to vocal fold hemorrhage and may be a sign of vocal overuse and misuse.

Electrolarynx

Device used to make artifical voice after laryngectomy, or removal of the voice box. This is held to the skin near the neck, and sound produced is transmitted to the mouth to make speech and words.

Electromyography – EMG

A test of the electrical activity of muscles. In the larynx it may be a test used in the management of vocal fold paralysis.

Endoscope

An instrument used to examine the “inside of a body”. Laryngoscopes, esophagoscopes, and bronchscope are specialized endoscopes used to examine the inside of someone’s body.

Endotracheal Tube

Breathing tube placed between the vocal folds in to the trachea during general anesthesia.

Epiglottis

Cartilage in the larynx which participates in swallowing. Usually the epiglottis can only be seen during laryngoscopy. The epiglottis is part of the supraglottis.

Epithelium

Cells that line the body. The epithelium, or outer layer of the vocal folds is different than the epithelium of the mouth and tongue.

Esophagogram

An X-ray study in which an individual

Esophagus

“Eating tube” that connects the throat to the stomach.

False vocal fold

Portion of the larynx, superior, or above the vocal folds. The false vocal folds do not participate in normal sound production, and come together during normal swallow to prevent aspiration.

FDA

Federal Drug Administration – Organization that approves the use of drugs for certain reasons. Drugs that are not “FDA approved” may still be used. Botulinum toxin, for example, is not FDA approved for laryngeal dystonia despite thousdands of patients treated over 20 years

FEES

Functional Endoscopic Evaluation of Swallowing – study performed to assess swallowing ability by placing an endoscope through the nose and determine if foods or liquids penetrate or aspirate into the larynx.

Feminzation laryngoplasty

Procedure performed to raise the pitch of a person

Fracture

A break. In the larynx it often refers to fracture of the laryngeal cartilage, due most commonly to trauma to the neck.

Frequency

Number describing the pitch of persons voice. Frequency is literally sound cycles per second, with the lower the number describing lower pitch. Male voices are typiclaly between 100 and 200 hertz, and females typically between 200 and 300 hertz.

Gastrostomy tube

Feeding tube placed into the stomach, either temporarily or permanently

GERD

Gastro esophageal reflux disease describes movement of acidic stomach contents “backwards” from the stomach to the esophagus, and may involve symptoms of heartburn.

Globus Pharyngeus

Sensation of an object ‘stuck in the throat’. Often times there is no such object. Symptoms may be attributed to reflux, amongst many other causes.

Glottal Fry

Sound produceed at a low pitch.

Glottal Incompetence

Incomplete closure of the vocal folds. Two common causes are vocal fold paralysis and vocal fold thinning associated with aging. Glottal incompetence may present as a breathy voice with fatigue.

Glottis

The vocal folds

Granuloma

Inflammatory tissue that usually forms on the posterior portion of the larynx, over the arytenoid cartilage.

Hematoma

A blood clot, that when on the vocal fold, may cause hoarseness. Vocal fold hematoma, or hemmorrhage is a “vocal emergency” and should be recognized early to prevent long term damage.

Hemorrhage

Bleeding, which when in the vocal fold, may cause hoarseness. This is a “vocal emergency” and should be recognized early to employ voice rest and prevent long term damage.

HPV

Human papilloma virus.

Human Papilloma Virus

A virus which is responsible for papilloma of the vocal folds as well as types of head and neck cancer, especialy tonsillar cancer.

Hydroxyapatite

The compound in Radiesse Voice which is used for vocal fold augmentation

Hyoid

The only bone of the larynx – the hyoid bone is below the mandible or jaw bone in the upper neck and is the “wishbone” in a turkey

Hypopharynx

The inferior, or bottom, portion of the throat. The three subsites of the hypopharynx are the posterior pharyngeal wall, piriform sinuses, and post-cricoid mucosa.

Idiopathic

Unknown’ – when diseases, such as vocal fold paralysis occur for unknown reason is termed ‘idiopathic’

Impedance

A probe is placed into the esophagus to test for flow of gas and liquids to confirm presence of gastroesophageal reflux disease.

Inpatient

Patient who stays the night in the hospital for administration of medicaiton and observation of symptoms.

Interarytenoid muscle

Muscle between the arytendoids, which, when contracts, causes vocal fold closure or adduction

Intubate

Introduction of an object – Intubation most often occurs to the process of placing an endotracheal tube into the mouth through the vocal folds into the trachea

Jet ventilation

A method of managing airway in surgery without use of an endotracheal tube. This involves administration of short bursts of air through a small catheter, and is used in certain types of laryngeal surgery.

Keel

Plastic placed between the vocal folds to separate them and prevent web formation

Keratin

A protein that may accumulate on the vocal folds to give a white appearance termed leukoplakia.

KTP

Potassium-titanyl-phosphate laser used in management of vocal fold lesions, including papilloma, leukoplakia, dysplasia, and cancer.

Laryngectomee

Person who has had laryngectomy

Laryngectomy

Removal of the voice box, or larynx, most often performed for cancer

Laryngitis

Inflammation fo the vocal folds often causing hoarseness

Laryngofissure

A surgery in which the larynx, or voice box, is divided along the midline to access vocal folds.

Laryngologist

An otolaryngologist (physician) who has a special interest in disorders of voice, swallowing and breathing. This requires a one-year fellowship after a five year otolaryngology residency.

Laryngomalacia

Collapse of the laryngeal cartilages inward which causes difficulty breathing.

Laryngoscope

A tool used to evaluate the larynx. A rigid laryngoscope is a metal hollow tube placed through the mouth and used to perform surgery under general anesthesia. A flexible laryngscope may be inserted through the nose with a patient awake to evalute the larynx. Flexible endoscopes permit minimally invasive office based procedures such as biopsies, injections and laser surgery.

Laryngoscopy

Examination and evaluation of the larynx. This may be performed using a laryngeal mirror, flexible laryngoscope, or rigid laryngoscope.

Larynx

Also known as the voice box, this a structure that is located atop the trachea and is involved in control of respiration, voice production, and swallowing.

Laser

Energy which is used in laryngology for management of many conditions from papilloma to cancer. Laser surgery may be performed in office or in the operating room.

Lower esophageal sphincter

The muscular valve that separates the esophagus from the stomach. Overactivity of this muscle may resut in difficulty swallowing. Tightening of the lower esophageal sphincter is performed in a nissen fundoplication, or surgical management of reflux disease.

Leukoplakia

“White plaque”. Leukoplakia is due to keratin on the vocal folds and may be associated with dysplasia, carcinoma in situ, or cancer of the vocal folds.

Lidocaine

Liquid used to numb, or anesthetize a portion of the body. It may be inhaled as a mist , placed as a liquid, or injected for throat anesthesia.

Lingual Tonsils

Tonsillar tissue on the back of the tongue which may contribute to chronic tonsillitis, globus sensation, or sleep apnea.

LMA

Laryngeal mask anesthesia. A method of providing general anesthesia without using a tube that touches the vocal folds. This has less incidence of laryngeal injury risk than an endotracheal tube, but is not always able to be sued.

Local Anesthesia

Medication used to numb only part of the body. Lidocaine and xylocaine are common local anesthetic medications.

LPR

Laryngopharyngeal reflux

Lymph Node

Small bean shaped structures whch are normally present in the neck and may enlarge as a result of infection, inflammation, or cancer.

Lymphadenopathy

Enlarged lymph nodes, which, when in the neck, may be palapble, or noted on ultrasound, CT, or MRI.

Laryngoscopy

Laryngoscopy is a procedure performed to examine the vocal folds. This is a surgical procedure performed in the operating room with the patient asleep. A laryngoscope, or hollow metal tube, is inserted into the mouth and advanced to the vocal folds.

A microscope or telescope provides a magnified view of the vocal folds. Through the laryngoscope instruments may be used to perform biospies of lesions, or even completely remove lesions such as cysts or polyps.

Through laryngoscopy, surgery such as cancer excision may be performed in a minimally-invasive manner.

Manometry

A tests of swallowing ability which measuers generation of pressure waves in the throat and esophagus.

Maximum Phonation Time

The maximum amount of time an individual can hold the letter e, which on average is 12-15 seconds. Patients with vocal fold paralysis and glottal incompetence may have limited maximum phonation time as short as two to three seconds.

MBSS

A radiographic swallow study in which a speech pathologist evaluates a patient swallowing foods of different consistencies. Xrays are taken during swallow to determine if aspiration or penetration occurs.

Medialization

The process of moving something to the middle. Medialization of the vocal fold may be performed through vocal fold augmenation injection, thyroplasty or arytenoid adduction in the magagment of vocal fold paresis and paralysis.

Microlaryngoscopy

Laryngoscopy performed in the operating room using a telescope or microscope to magnify the view of the vocal folds.

Mitomycin C

A chemotherapeutic agent which is used in the management of scars of the subglottis and trachea.

Mucosa

Inner lining of the mouth and throat which normally secretes fluid for lubrication.

Muscle Tension Dysphonia

A condition of voice overuse in which the false vocal folds and strap muscles are overactive in production of sound.

Myotomy

Cutting of a muscle. Cricopharyngeal myotomy is performed for treatment of Zenker’s Diverticulum.

Nasogastric tube

A small tube placed through the nose, into the stomach. This may easily be placed with a patient awake. Patients are fed three to four times a day with liquid through the nasogastric tube. It is often used after throat surgery such as cricopharyngeal myotomy or Zenker’s Diverticulectomy, to allow tissues to heal before feeding by mouth takes place. A nasogastric tube is a temporary feeding tube which may be removed with the patient awake as well.

Nasopharynx

The portion of the throat immediately behind the nose. The nasopharynx is the location of the adenoids and may be a site of an uncommon type of cancer. Nasopharynx may be visualized with endoscopy.

Nissen Fundoplication

A surgery performed to treat reflux in which the lower esophageal sphincuter, or valve between the esophagus and stomach is tightened to prevent food and acid from refluxing in to the throat.

Nodules

A callus of the vocal fold creatd by vocal overuse and misuse which causes hoarsness.

Odynophagia

Pain with swallowing which can be due to anything from reflux to cancer. Painful swallowing should be evaluated by physican

Oropharynx

The portion of the throat from the soft palate to the tip of the epiglottis. A physician can examine the oropharynx by having a person say “ahh” and looking through the mouth, or by performing a laryngosocpy.

Otalgia

Pain in the ear, which can be a sign of throat cancer.

Otolaryngologist

An physician who specializes in surgery of the ear, nose and throat. After medical school a five year residency training program and passage of a board examination certifies someone in otolaryngology.

Outpatient Surgery

Refers to a surgery performed ‘same day’ without the need for a patient to spend the night in the hospital.

Panendoscopy

The triad of laryngoscopy, bronchscopy and esophagoscopy performed in evaluation of head and neck cancer. Panendoscopy is performed by an otolaryngologist to evalate for cancer spread and to examine for other, distinct cancers.

Papilloma

Papiloma are wart like growths which often occur in the throat on the vocal folds causing hoarseness. They may also occur throughout the throat causing symptoms such as shortness of breath or dysphagia.

Paralysis

Inability to move. Vocal fold paralysis can result in symptoms of hoarsness and shortness of breath.

Paresis

Decreased mobility. Vocal fold paresis is often reversible, improving with time. Patients with paresis may experience hoarseness or no symptoms at all depending on extent of injury.

PDL

Pulsed-dye laser.

pH

A number used to measure the acidic content of a substance.

pH probe

A probe from through the nose into the oropharynx or esophagus to measure the amount of acid refux from the stomach. This is typically a 24 hour test.

Phlegm

Secretions found in the throat including saliva, nasal secretions and sometimes acid secretions from the stomach.

Pitch

The frequency of a sound determined the the wavelength of a sound wave.

Polyp

A growth of tissue which can occur in the midportion of the vocal fold often associated with vocal overuse. This is a non-cancerous, or benign, lesion.

Presbylarynx

The aging larynx, which results in vocal fold thinning and decreased neural control of the larynx. Patients with presbylarynx may have symptoms of hoarseness, decreased loudness, and tiring while speaking. Others may develop symptoms of difficulty swallowing.

Pulsed dye laser

A laser used in management of vocal fold lesions, including papilloma, leukoplakia, dysplasia, and cancer.

Radiation therapy

The use of energy to treat cancer. Radiation therapy is administered over multiple treatments, usually five days a week for a period of four to six weeks.

Radiesse

Calcium hydroxyapatite product using in vocal fold augmentation.

Recurrent Laryngeal Nerve

A nerve which controls vocal fold motion. The recurent laryngeal nerve is a branch of the tenth nerve or vagus nerve. It originates in the brain, travels in the neck to the chest and then loops backwards to the larynx. Problems with the recurrent laryngeal nerve may result in vocal fold paralysis.

Recurrent respiratory papillomatosis.

Papillomas cuased by the human papilloma virus which commonly occur in the vocal fold and trachea, causing symptoms of hoarseness and shortness of breath.

Reinke’s edema

Polyp of the vocal fold associated with smoking, reflux, and often times female gender. It is due to excess tissue in the superifical layer of the lamina propria and may be treated with laser or surgery.s

Respiration

The act of breathing.

RFS

Reflux finding score. A physician grades portions of a laryngoscopy to determine whether signs of laryngopharyngeal reflux are present.

RRP

Recurrent respiratory papillomatosis.

RSI

A questionairre which evaluates for the presence of laryngopharyngeal reflux

Salivary gland

There are four major salivary glands and numerous minor salivary glands. These produce saliva which assist in digestion.

Scrubbing in

Scrubbing in describes the procedure where a surgeon cleans his nails, fingers, hands and arms prior to wearing sterilized gloves and gowns in order to perform surgery

SD

Spasmodic Dysphonia

Sedation

Administration of medication to reduce alertness and anxiety. Sedation may be a form of twilight anesthesia commonly used during thyroplasty.

Silent reflux

Reflux of acid contents into the throat causing laryngopharyngeal reflux without traditional symptoms such as heartburn and chest pain.

Soft palate

Portion of the palate which is muscular and located in the back portion of the mouth. The soft palate is important in swallowing and speech production.

Spasmodic Dysphonia

Laryngeal dystonia. A condition in which the vocal folds involuntarily contract. There are two main types – abductor and adductor type spasmodic dysphonia.

Speech Language pathologist

An individual with special interest in management of speech, language and swallowing disorders. A speech language pathologist typically obtains a masters degree or doctorate after college.

Squamous cell cancer

Most common cancer of the head and neck and throat. Most forms of throat cancer including laryngeal cancer are squamous cell cancer. This diagnosis can only be made by a biopsy.

Stenosis

Narrowing of a tube – in the throat stenosis of the trachea and subglottis cause difficulty breathing. Stenosis of the hypopharynx and esophagus cause difficulty swallowing.

Strap muscles

Muscles located just under the skin on the ‘front’ of the neck which attach to the hyoid bone and larynx, and participate in swallowing

Stridor

Noisy breathing, which may be a sign of a fixed throat lesion such as bilateral vocal fold paralysis, subglottic stenosis and tracheal stenosis.

Subglottis

The portion of the larynx immediately below the vocal folds. This is the narrowest portion of a persons airway and may be the site of subglottic stenosis.

Superficial Layer of the lamina propia

The criticial layer of the vocal fold which enables a mucosal wave to occur producing sound. Cysts and nodules often occur in the superifical layer of the lamina propria affecting sound production.

Superior laryngeal nerve

A nerve which controls sensation of the throat and movement of the cricothyroid muscle. The superior laryngeal nerve is a branch of the vagus. Deficits in this nerve may result in dysphagia and aspiration.

Synkinesis

Abnormal innervation. In the vocal fold after damage to the recurrent laryngeal nerve, synkinesis may occur when nerve fibers are interrupted and regrow in a misdirected fashion. Synkinesis may be favorable, causing no complaints, or unfavorable causing voice, swallowing, or breathing problems.

TEP

Tracheoesophageal puncture

Thulium laser

Laser which targets water molecules preferentially and used in management of many diseases, from papilloma to cancer

Thyroarytenoid muscle

A muscle of the vocal fold which tenses and brings the vocal folds together for sound production.

Thyroid cartilage

Cartilage in the neck also known as adam’s apple which is part of the larynx and protects the vocal folds.

Thyroid gland

A butterfly shaped gland that is located in the lower neck with secretes thyroid hormone, which contributes to many bodily functions.

Thyroid hormone

Hormone secreted by the thyroid gland which contributes to many bodily functions.

Thyroplasty

A surgery performed in which the vocal fold position is altered to affect the voice. There are four common types of thyroplasty.

Thyroplasty, Type I

A surgery in which a cut is made on the neck and the vocal fold is moved to the midline to improve voice for a patient with vocal fold paralysis, presbylarynx, or othe forms of glottal incompetence.

Thyroplasty, Type II

A sugery in which a cut is made on the neck and the vocal fold are moved apart, used in the treatment of spasmodic dysphonia.

Tonsil

Lymphoid tissue located in the back fo the mouth, on the tongue and in the nasopharynx. Tonsils may become infected causing pain, enlarged causing difficulty swallowing and breathing, may be a site of cancer.

Trachea

The windpipe or breathing tube that connects the throat to the lungs

Tracheal shave

Cosmetic procedure designed to reduce the size of the thyroid cartilage, or Adam’s apple

Tracheoesophageal Puncture

A plastic device inserted through a procedure into the neck to help in the creation of artificial speech after laryngectomy.

Tracheotomy Tube

Removable tube, either plastic or metal, placed through the neck into the airway

Tracheotomy scar

A tracheotomy scar is a formed after a tracheotomy tube is removed. Tracheotomy scars may be very difficult to see. However, sometimes tracheotomy scars are unsightly and very large. In some instances trachetomy scars involved not only the skin of the neck but also the muscles and even the trachea itself. When this occurs the scar is very deep and each time the patient swallows the scar is pulled making it difficult to eat or drink.

A tracheotomy scar revision is a surgery in which the scar is removed.

UES

Muscular sphincter between the throat and esophagus.

Ultrasound

A medical test using sound waves to examine anatomy. Ultrasound can be used in the throat for evaluation of lymph nodes and the thyroid gland. Ultrasound does not emit radiation.

Vagus Nerve

The tenth cranial nerve which controls voice production, sensation of the throat and swallowing.

Valeculla

Space between the base of tongue and epiglottis

VCD

Vocal cord dysfunction.

Ventilate

The act of breathing and exchanging air in the lungs.

VHI

Voice handicap index.

Videostroboscopy

Examination of vocal fold movement using stroboscopic light. This light is specially applied to examine the motion of the vocal folds in slow motion. It allows for detailed evaluation of a mucosal wave and permits for detection of cysts, polyps, nodules and other laryngeal conditions.

Vocal cord dysfunction

A condition in which the vocal folds close causing patients shortness of breath. Sometimes these are termed “breathing attacks”. Often the treatment is therapy provided by a speech language pathologist.

Vocalis muscle

Muscle of the larynx which causes the vocal folds to adduct.

Voice Disorders

Voice handicap index
A questionaire that measures the effect of hoarsness or dysphonia on an individual. Two indices exist – a 10 question and a 30 question test.

Voice rest

A period in which a patient is asked to not speak or whisper. This is usually anywhere from three days to fourteen days in length. Patients are often asked to observe a period of voice rest after surgery to allow for tissues to heal.

Voice-related quality of life

A questionaire that measures quality of life effect on an individual with dysphonia or hoarseness

VRQOL

Voice-related quality of life questionairre

Web

A bridge of tissue extending from one vocal fold to the other. These can be congenital in which an individual is born with the web, or develop as a result of trauma and inflammation.

Wegener’s

A granulomatous disease that may present with throat symptoms such as subglottic stenosis and shortness of breath.

Zenker’s

A pouch that forms in the back of the throat due to an overactive cricopharyngeus muscle. This occurs most often in individuals over the age of 60 and causes difficulty swallowing.