As regards the value of skiagraphy, Walsham and myself have found that photographs can be made of tumours of the larynx which in some instances determine accurately the position and extent of the disease.
Fig. 254. Skiagram showing a Tumour of the Larynx. A, Tumour; B, Body of hyoid; C, Greater cornu of hyoid; D, Epiglottis; E, Posterior plate of cricoid; F, Vocal cord; G, Trachea; H, Œsophagus.
Fig. 254 is a photograph showing a cancer of the upper opening of the larynx, lying above the vocal cords, the position of which was proved to be accurate by later operation upon the patient. It is, however, doubtful whether the method will eventually assist in the differential diagnosis between innocent and malignant growths.
(ii) Tuberculosis. Endolaryngeal operations are successfully performed for chronic conditions such as ulceration or tumour, and, rarely, in acute forms such as abscess, necrosis, and the like. Removal of a portion of the epiglottis occasionally gives great relief to a patient who is suffering from dysphagia.
(iii) Strictures resulting from trauma, from the ulcerations of syphilis, diphtheria, and other inflammatory diseases, or caused by congenital webs.
(iv) Foreign bodies impacted in the larynx.
(v) Œdema of the mucous membrane due to trauma or inflammation, local abscess, necrosis, and other allied conditions, in which obstruction is likely to supervene.
The operation may be performed either by indirect or by direct laryngoscopy.