Laryngeal Tumors

Anatomy of the Condition

The larynx or voice box begins at the back of the throat. It extends down, carrying air from the nose and mouth to the trachea and then into the lungs. Several types of laryngeal tumors can occur in the larynx. At Emory Voice Center, we treat benign laryngeal tumors and malignant laryngeal tumors.

Laryngeal papillomatosis is a common benign laryngeal tumor. The human papillomavirus (HPV) causes this condition. Between 60 and 80 percent of all cases of laryngeal papillomatosis occur in children. The causes and reasons for spread of the virus are largely unknown. More than 60 identified strains of the HPV virus can cause papillomatosis. These growths can cause vocal cord damage and airway problems.

A variety of malignant tumors can also arise in the larynx.

More than 60 strains of human papillomavirus (HPV) can cause laryngeal papillomatosis. It is still unclear how people contract the virus.

Risks factors for cancer of the larynx include:

• Smoking
• Heavy alcohol consumption (especially when combined with smoking)
• Age (laryngeal cancer is more common in people over 55)
• Gender (men are four times more likely than women to contract the disease)
• Race (African-Americans have a higher incidence of laryngeal cancer)
• Exposure to materials such as asbestos or other cancer-causing environmental substances

All forms of laryngeal tumors can manifest with similar symptoms. If you experience chronic or persistent bouts of the following symptoms, see your physician.

Symptoms include:

• Hoarseness
• Chronic coughing
• Difficulty breathing
• Sensation of a lump in the throat
• Rough or scratchy voice
• Difficulty or pain with swallowing
• Ear pain
• Voice weakness and strain

Our team will discuss your symptoms and medical history. We will perform a thorough head and neck examination. Our evaluation team often involves several members of the Emory Voice Center. We will assess vocal quality, efficiency, and proper speaking technique.

We may complete a laryngeal videostroboscopy. In this minimally invasive procedure, we use an endoscope (a small tube equipped with a fiber optic camera.) A stroboscopic light source lets us check laryngeal function and vibration.

We may complete a direct laryngoscopy or microlaryngoscopy. A physician will examine the vocal folds of the larynx with magnification tools. We conduct this procedure under general anesthesia. The physician may take tissue samples for biopsy or remove a mass or tumor.

We can remove laryngeal papillomas with several techniques. We are the only center in a 150 mile radius that offers awake KTP laser ablation of the lesions. This is a minimally invasive technique that can be done with an awake patient to treat mild to moderate amounts of papilloma. Patients tolerate this well, can drive themselves to and from their procedures, and can often return to work on the same day of treatment.

The KTP laser as well as a carbon dioxide laser can be used with a patient under general anesthesia in the operating room. These techniques, among others, are employed to help minimize damage to normal healthy vocal fold tissue.

We additionally offer immunization with Gardasil to help treat the potential viral cause of the papilloma. Early research indicates this slows the progression of papilloma growth. Severe cases of laryngeal papillomatosis may require further medical treatment such as chemotherapy.

Treatment for laryngeal cancer depends on the type of malignancy and the stage at which the condition is diagnosed. Surgery, chemotherapy, and/or radiation therapy may be required. We present patients with laryngeal malignancies at the multidisciplinary Emory head and neck cancer tumor board. This helps us optimize and individualize treatment.