. Twentieth century practice; an international encyclopedia of modern medical science by leading authorities of Europe and America . is rendered difficult by thedrawing down of the epiglottis upon the larynx. It may indeed bealmost or quite destroyed, in which case the entrance to the larynxis seen as a rounded, ragged circle, below which in a gradually nar-rowing space we perceive the ventricular bands merged into the true cords, covered in places by cicatri-cial tissue, and separated by puffy,purplish mucous membrane. Anarrow breathing-space is usuallyleft in front of the posterior com-missu
. Twentieth century practice; an international encyclopedia of modern medical science by leading authorities of Europe and America . is rendered difficult by thedrawing down of the epiglottis upon the larynx. It may indeed bealmost or quite destroyed, in which case the entrance to the larynxis seen as a rounded, ragged circle, below which in a gradually nar-rowing space we perceive the ventricular bands merged into the true cords, covered in places by cicatri-cial tissue, and separated by puffy,purplish mucous membrane. Anarrow breathing-space is usuallyleft in front of the posterior com-missure, as the adhesions betweenthe cords generally occur anteriorly(see Fig. 61). No two cases are exactly similarand we may have marked stenosisas the result of ulceration and ci-catrization, and chiefly confined toone side of the larynx. The ste-nosis is materially increased by theusually early involvement of thecrico-arytenoid articulation on one or both sides, resulting in a fixa-tion at or near the median line, the situation of the fixation beingprobably due to the fact that the abductor muscles are weaker thanthe Fig. 61.—Cicatricial Stenosis of the Larynxthe Result of Syphilitic Ulceration. CouESE AND Prognosis of Laryngeal Syphilis. Laryngeal syphilis with its sequelae may extend over a number ofyears. If treated at the onset it may be arrested, but if ulcerationhave occurred, some tissue will necessarily be destroyed, and no localor general treatment can control the cicatrization and contractionwhich are sure to follow. Prognosis as to the question of vocal im-pairment and preservation of the air passage must be based upon theamount of destruction which has taken place at the time, and theprobable amouut of resulting contraction. Dyspnoea and suffocation are the only elements of danger to life,and can be averted by the prompt performance of tracheotomy. syphilis of ihe lak\\x. 393 Treatment of Laryngeai, Svi-hius. The Prinmrj/ Ulcer.—Liirviif^cal cliaiicn)
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Keywords: ., bookcentury1800, bookdecade189, booksubjectmedicine, bookyear1895
