. A manual of diseases of the nose and throat. e voice. Singers find difficulty in strikingthe right note, and in holding it when once speakers find their voices crack in the midstof talking. The other symptoms depend upon theamount of the associated hypertrophic laryngitis, whichnot infrequently is very slight. Examination. Examination of the larynx reveals aslight whitish, grayish, or very light pink elevation onthe vocal cords near their internal margins (Fig. 92). CHRONIC HYPERTROPHIC LARYNGITIS. 441 These frequently project almost straight inward fromthe thin, inner margin
. A manual of diseases of the nose and throat. e voice. Singers find difficulty in strikingthe right note, and in holding it when once speakers find their voices crack in the midstof talking. The other symptoms depend upon theamount of the associated hypertrophic laryngitis, whichnot infrequently is very slight. Examination. Examination of the larynx reveals aslight whitish, grayish, or very light pink elevation onthe vocal cords near their internal margins (Fig. 92). CHRONIC HYPERTROPHIC LARYNGITIS. 441 These frequently project almost straight inward fromthe thin, inner margins of the vocal cords, thus makinglittle lumps or nodes plainly visible, interrupting theotherwise slightly curved edge of the normal mucous membrane in the immediate neighborhoodof these nodes is apt to be slightly reddened when com-pared with the other regions of the cord. Prognosis. When patients can be induced to followimplicitly the directions of the physician, especiallyin regard to giving the voice a needed rest, and Fig. Nodes on the vocal cords; that on the right cord is somewhat the larger. where they subsequently correct faults in speakingor singing, these growths usually disappear and donot return. If, however, instructions are disobeyed,the growths, if removed, are apt to return. Treatment. The first and most important point in Q^sj^the treatment is to give the voice absolute rest. Inslight nodule formation this alone is sufficient, after aperiod of from three to six months, to allow of absorp- -tion of the thickened epithelium and a return to the ^/r^ ,normal condition. Zinc chloride, applied in themanner described in the treatment of chronic diffusehypertrophic laryngitis, usually materially assists in 442 DISEASES OF THE LARYNX. the absorption of these growths. Where the nodulesnfe^w^-C. are large it is often necessary to remove the greater<*^vw*£ portion of them by means of the punch forceps (~,lU m 106). The larynx should be thoroughl
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