. A manual of diseases of the nose and throat. ay also result THE NEUROSES OF THE LARYNX. 521 from severe inflammatory diseases of the pharynx, inwhich there is considerable infiltration of the submu-cous tissues. Tubercular and syphilitic infiltrations inthe interarytenoid space frequently involve the muscleor mechanically interfere with its action. Symptoms. The symptoms most complained of inthis condition are hoarseness of the voic,e and fatiguein talking. The hoarseness is due to the imperfect ap-proximation of the posterior ends of the vocal cords,and the fatigue is due to the escape of a
. A manual of diseases of the nose and throat. ay also result THE NEUROSES OF THE LARYNX. 521 from severe inflammatory diseases of the pharynx, inwhich there is considerable infiltration of the submu-cous tissues. Tubercular and syphilitic infiltrations inthe interarytenoid space frequently involve the muscleor mechanically interfere with its action. Symptoms. The symptoms most complained of inthis condition are hoarseness of the voic,e and fatiguein talking. The hoarseness is due to the imperfect ap-proximation of the posterior ends of the vocal cords,and the fatigue is due to the escape of a considerablevolume of expired air, so that the force of the columnof air is insufficient to cause the vocal cords to vibrateproperly. When this fatigued condition is marked thevoice in consequence is often aphonic. Respiration isnot interfered with. Examination. Examination of the larynx reveals atriangular opening at the posterior portion of the vocalcords, the apex of the triangle being directed towaidthe epiglottis (Fig. 120). , Fig. Paralysis of the arytenoideus. Treatment. The treatment is the same as that givenfor unilateral abductor paralysis, with the exception ofthose cases which are due to hysteria, in which tonicsand nerve sedatives are to be administered. 522 DISEASES OF THE LARYNX. (d) Unilateral Paralysis of One Internal Tensorof the Vocal Cords. The internal tensors of the vocal cords are the thyro-arytenoidei, which run parallel to, external, and beneaththe vocal cords. Etiology. One of these muscles may be involved inan inflammatory thickening or infiltration of the vocalcord and the tissues external to it. It is seen inchronic subglottic laryngitis, occasionally in chronicdiffuse hypertrophic laryngitis, in malignant and non-malignant growths of the larynx, and in tuberculosisand syphilis. The disease often results from prolongeduse of the cords, especially when the general health ofthe patient is not in the best condition. It is occa-sionally observed
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