. A manual of diseases of the nose and throat. us membraneof the larynx is swollen and bright red in appear-ance. Very characteristic of the tubercular stage is apale, pear-shaped, edematous swelling found in theary-epiglottic folds, obliterating the little nodule whichindicates the position of the cartilage of characteristic pear-shaped swelling is shown asbeing larger on the left than on the right in Fig. 110,and of equal size on both sides in Fig. 111. Wherethe tubercles are small and situated just beneaththe mucous membrane they appear as grayish elevationsthe size of the hea
. A manual of diseases of the nose and throat. us membraneof the larynx is swollen and bright red in appear-ance. Very characteristic of the tubercular stage is apale, pear-shaped, edematous swelling found in theary-epiglottic folds, obliterating the little nodule whichindicates the position of the cartilage of characteristic pear-shaped swelling is shown asbeing larger on the left than on the right in Fig. 110,and of equal size on both sides in Fig. 111. Wherethe tubercles are small and situated just beneaththe mucous membrane they appear as grayish elevationsthe size of the head of a pin. These are frequentlyseen on the epiglottis, ary-epiglottic folds, and ven-tricular bands. The tubercles are frequently massed TUBERCULOSIS OF THE LARYNX. 465 so as to form a distinct tumor, which may be small anduneven, as shown in the interarytenoid space (Fig. 4,Plate VII.), or as forming a large, tabulated tumor inthe same region (Fig. 5, Plate VII.). They are occa-sionally wart-like, as in Fig. 111. Slight ulceration Fig. Tubercular infiltration of the interarytenoid space with tubercular papil-lomata of both vocal cords. Characteristic edematous infiltration of theary-epiglottic folds. (Cohen.) and crust formation may be seen covering the surfacesof these tumors. Small ulcers are frequently foundwhen these crusts are removed. Tlie appearance of anythickening in the interarytenoid region of the larynx in apatient who has pulmonary tuberculosis is almost certainevidence that this portion of the larynx is involved bytubercle. Stage of Ulceration. Examination of the larynxin the ulcerated stage invariably shows edematousinvolvement^of thp a ry-ppjglottic folds. If an ulcer issituated on the epiglottis, the accompanying edema willcause it to be thickened, swollen, pale, and turban-shaped, so as often to make it impossible to viewthe interior of the larynx. When the ulcer is situ-ated within the larynx, on the ventricular bands, asshown in Fig. 110 on the left
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