PHARYNGEAL AND LARYNGEAL POLYPI.
Pediculated tumors. Dyspnœa through change of position, operation by ecraseur, snare, or cricoid incision.
Tumors of varied structure developing in or beneath the mucosa of pharynx or larynx often become slowly detached until they hang by a loose pedicle, and having much latitude of movement they may at times slip between the arytenoid cartilages or even into the glottis producing the most urgent or even fatal dyspnœa. Pediculated tumors in the posterior nares lead to the same accident. In one case of multiple small tumors on the pharyngeal mucosa of the horse, the largest and loosest, attached to the front of the epiglottis, was occasionally displaced into the larynx threatening instant asphyxia. One such attack supervened on the opening of a suppurating guttural pouch by the writer, necessitating prompt tracheotomy. A time was set for the removal of the polypus, but the tracheotomy tube having been accidentally displaced during the preceding night the patient died of suffocation. Dick mentions a polypus growing from the interior of the larynx and causing loud roaring. Such tumors may be removed by operating with the ecraseur through the mouth, or by a snare passed through a long narrow tube and used to seize and twist through the pedicle. If the polypus grows from the laryngeal walls, it may be best reached by incision through the cricoid cartilage and crico-thyroid membrane as in the operation for roaring.