The term “pharyngeal polypi” includes tumours of varying character, which affect the polypus form, and occur with considerable frequency in the bovine species. Many of these polypi are simply actinomycotic growths springing from the pillars of the fauces, from the upper parts of the palate or from its posterior surface. Less frequently they arise from the lateral walls or the free surface of the hard palate.
Symptoms. The symptoms are so characteristic that the diagnosis rarely presents much difficulty. They may shortly be described as indicative of repeated obstruction in the pharyngeal, œsophageal or laryngeal region. At the moment of deglutition, the polypus is thrust towards and obstructs the œsophageal orifice.
Reflex stimuli are thus excited, which prevent deglutition; an attack of coughing occurs, and food mixed with saliva is ejected from the mouth and nostrils. The attack of coughing displaces the polypus either in a forward or lateral direction, and swallowing then again becomes possible, until by changing its position the growth produces fresh signs of obstruction.
In other cases the polypus may only be of such small size as to impede the food passing through the pharynx on its way into the œsophagus or to cause difficulty in respiration by partially blocking the pharyngeal portion of the nasal cavities. In such cases deglutition is only checked and rendered slower.
Or again, the pedicle of the polypus may be sufficiently long to allow the growth at certain moments to fall in front of the laryngeal opening. Respiration is then painful, difficult and noisy. Unless the growth is displaced during the subsequent attack of coughing, asphyxia may appear imminent, or may even occur unless assistance is afforded.
Guided by these symptoms, the operator will explore the pharynx manually, and thus discover the position and size of the tumour. Tumours of the naso-pharynx produce very similar symptoms.
The prognosis is based on the information obtained by manually exploring the pharynx. It is relatively favourable if the polypus has a well-marked neck, but is very grave if the tumour is largely sessile and cannot be removed.
Treatment. Medical treatment appears useless except in cases of polypi due to the presence of actinomyces. The administration of iodine and iodide of potassium, in large doses, may then lead to resorption; but extirpation is often preferable.
In other cases extirpation is the only rational treatment. The operation necessitates the performance of provisional tracheotomy in order to avoid risk of asphyxia. The growth may be directly removed through the buccal cavity without incision, provided that it prove possible to pass the chain of an écraseur around the pedicle; or through the buccal cavity, with incision, after vertically or obliquely dividing the soft palate; or, lastly, through the larynx, after performing median laryngotomy, thus obtaining access to the pharynx.
Only the first method of intervention is to be recommended; the last two are more delicate. They necessitate after-treatment, and when the patients are in a condition for slaughter it is frequently preferable to send them to the butcher. The essential point is not to act without a full knowledge of the causes.