Throat sore to touch

Laryngeal Cancer and Pain at Base of Throat

Beyond that, I would discuss your concerns with your doctor and to come up with a plan for cancer surveillance that you feel comfortable with.

Q6. My doctor said we could try targeted therapy for my throat cancer. I don’t understand what that means. She said it wasn’t the same thing as traditional chemotherapy.

In general, targeted therapy refers to a class of drugs that “target” a specific biologic pathway or a specific chemical, protein or cell important in the growth of cancer cells. One of these, the epidermal growth factor receptor (EGFR) is an important regulator of cancer cell growth and is found on the surface of many head and neck cancer cells. Targeted therapies such as cetuximab (Erbitux) can bind to these receptors and disrupt the cellular pathways that control cell growth.

Other drugs in this class can target molecules associated with EGFR that disrupt the communication between these receptors and the nucleus of the cell.

In simpler terms, if chemotherapyis a “dumb bomb” that kills both normal cells and cancer cells, targeted therapies are “smart bombs” that kill only cancer cells. Currently, targeted therapies for oral, head and neck cancer are used in conjunction with more conventional treatments such as chemotherapy and radiationtherapy and are not approved as stand-alone therapy.

Q7. I was treated for stage II laryngeal cancer nearly six years ago and haven’t had a relapse. Does that mean I’m cured? If not, what are my chances that the cancer will come back?

First of all, congratulations. Living through cancer treatment is truly an accomplishment, and I continue to be amazed at the resilience of my own patients who have persevered and have come out the other side — a little battered, perhaps — but cancer survivors.

For most head and neck cancers, the first 12 months from the time you complete treatment is the most critical time, as most recurrences will occur during this period. Every year after the first year, your chance of recurrence goes down. After five years, many people will consider a patient “cured” because the odds of a recurrence at that point are so low.

Having said all of this, if you have survived an advanced cancer, constant vigilance and follow-up are still warranted. Cancer can be a lifelong health issue for many patients. Depending on the type of cancer, recurrences can occur many years after initial treatment. Careful follow-up helps you and your doctor catch any recurrence early, and early detection is the key to long-term survival. So, keep up with your follow-up. If you are a former smoker, it is never safe to go back to smoking. Eat sensibly and well, and take care of your body with regular exercise. You may have to live with cancer, but you can choose to live well.

Q8. My husband was diagnosed with larynx cancer (stage IV) this spring. He has had two sessions of chemotherapy (carboplatin), both of which have been horrific. He is almost incoherent, and the fatigue is incredible. I don’t know if he can take a third session. If you reduce the amount of chemotherapy to reduce side effects, do you still get the same benefit? Or are you just stuck with a certain amount if you want to get better?

For some advanced laryngeal cancers, induction chemotherapy is used to shrink the tumor volume as to make it more amenable for surgery, or as a pretreatment for definitive chemo-radiation therapy. Due to the higher doses of chemotherapy needed in induction therapy, the side effects can be very pronounced. Unfortunately, these doses are also very important in killing the cancer. So in a very real way, there is a race between how much it takes to kill the cancer and how much your body can tolerate.

If your husband has had two sessions of induction chemotherapy, and he is having significant problems, it may be time to re-evaluate the treatment plan. If there has been a significant response to the chemotherapy, surgery may now be an option. Alternatively, he may now be ready for definitive chemo-radiation. I would discuss these issues with your cancer treatment team.

Q9. My oncologist told me about a new kind of chemotherapy called cetuximab for pharyngeal cancer. She said it has fewer side effects. Can I try it, or is it still considered experimental?

Cetuximab is the generic name for the brand-name medication Erbitux, which is a monoclonal antibody that attaches itself to the epidermal growth factor receptor (EGFR) located on the surface of some cells. This is an important pathway in the growth of some cancer cells, including the most common type of head and neck cancer.

Cetuximab is in a class of drugs best thought of as “targeted therapy.” Unlike more traditional chemotherapies that act broadly on many cell types, drugs like cetuximab target specific molecular pathways involved in cancer cell growth. These targeted therapies represent a potential future direction in the treatment of head and neck cancer and are usually given in conjunction with more traditional therapies such as radiation and chemotherapy. Their efficacy as stand-alone therapy is not proven. Cetuximab is approved by the Food and Drug Administration for use in combination with radiation therapy for the treatment of locally or regionally advanced squamous cell cancer of the head and neck. It is also approved for the treatment of recurrent or metastatic squamous cell cancer of the head and neck that has progressed after chemotherapy with platinum-based drugs.

Cetuximab is given intravenously. Other drugs in this class are available in a pill form, an additional benefit.

Studies have shown that cetuximab has its greatest benefits in cancers expressing high levels of EGFR, and your doctor may recommend that your cancer be tested for EGFR levels. Some side effects of this drug include a very severe skin rash and/or acne, because skin has high levels of EGFR.

Cetuximab has moved from clinical trials into more mainstream treatment plans, and although I would not consider it experimental, it is not a “magic bullet” for cancer either. As always, I would thoroughly discuss the pros and cons of any treatment plan with your doctor before you start.

Learn more in the Everyday Health Oral, Head, and Neck Cancer Center.

What’s Causing the Pain in the Front of My Neck?

The possible causes of neck pain range in type and severity. To determine what you have, take note of your other symptoms.

Sore throat

Typically, front neck pain is caused by a sore throat. This is usually due to a minor condition, such as:

  • common cold
  • flu (influenza)
  • laryngitis
  • tonsillitis
  • strep throat

You might also get a sore throat from:

  • dry air
  • allergies
  • air pollution

The symptoms of a sore throat depend on the specific cause. In addition to pain in the front of the neck, it can lead to:

  • scratchiness
  • difficulty swallowing (dysphagia)
  • pain when swallowing or talking
  • swollen tonsils
  • hoarse voice
  • white patches on your tonsils

Swollen lymph nodes

Another common cause is swollen lymph nodes. Your lymph nodes are small, oval-shaped structures that contain immune cells. They help keep you healthy by filtering out germs like bacteria and viruses. Lymph nodes are located throughout your body, including your neck.

When you’re sick, the immune cells in your lymph nodes can multiply as they fight germs. This can make the lymph nodes in your neck swell, causing pain and discomfort.

Swollen lymph nodes may be caused by:

  • common cold
  • flu
  • sinus infections
  • mononucleosis
  • upper respiratory infections
  • strep throat
  • skin infection
  • cancer (rarely)

Along with front neck pain, swollen lymph nodes can cause:

  • ear pain
  • runny nose
  • tenderness
  • soreness
  • fever
  • sore throat

Cramp

Neck cramps are the sudden, spontaneous tightening of one or more muscles in your neck. They’re also known as neck spasms.

When a neck muscle suddenly contracts, it can make the front of your neck hurt. Possible causes for muscle cramps include:

  • overexertion
  • dehydration
  • extreme heat
  • extreme temperature changes
  • sleeping in an awkward position
  • emotional stress

Other symptoms of neck cramps include:

  • stiffness
  • weakness
  • shoulder pain
  • headache

Muscle strain

A muscle strain happens when muscle fibers are stretched or torn. It’s sometimes called a pulled muscle.

In the neck, muscle strains usually occur due to overuse. This might be caused by activities like:

  • bending over a smartphone
  • looking up for too long
  • sleeping in an awkward position
  • reading in bed

You may have front neck pain, especially if you strain a muscle in the side of your neck. Other symptoms include:

  • shoulder pain
  • headache
  • soreness
  • difficulty moving your head

Whiplash

Whiplash is an injury where your head suddenly moves forward, backward, or sideways. The abrupt movement can damage the muscles, tendons, and ligaments in the neck.

The injury can happen during a:

  • motor vehicle collision
  • fall or slip
  • blow to the head

You can develop pain in your neck, including the front area. Other symptoms include:

  • difficulty moving your head
  • stiffness
  • tenderness
  • headache

If you were in a collision, visit a doctor immediately.

Heart attack

A less common cause of front neck pain is a heart attack. The pain from your heart can travel to the front part of your neck.

While some heart attacks appear suddenly, others begin slowly. It’s important to get emergency help even if you have mild symptoms.

Medical emergency

If you think you might be having a heart attack, call 911 and go to the nearest emergency room. Symptoms include:

  • chest pain
  • pressure or squeezing in the chest
  • pain in the jaw, back, or stomach
  • pain in one or both arms
  • shortness of breath
  • cold sweat
  • nausea

These symptoms can appear with or without chest pain.

Cancer

In rare cases, pain in the front of the neck indicates cancer. This may be due to swollen lymph nodes or a tumor in the area.

The following types of cancer can cause front neck pain:

  • Throat cancer. Throat cancer can affect the throat, voice box, or tonsils. It can cause pain in the neck and throat, especially when you swallow.
  • Esophageal cancer. In cancer of the esophagus, swallowing problems can lead to neck pain. Sometimes, it also causes chest pain, which may radiate to the neck.
  • Thyroid cancer. Symptoms of thyroid cancer may include swelling and pain in front of the neck. The pain can spread to the ears.
  • Lymphoma. Lymphoma, or cancer of the lymphatic system, causes swollen lymph nodes. If it develops in your neck, you may have pain and discomfort.

Carotidynia

The carotid arteries bring blood to your brain, scalp, face, and neck. You have one carotid artery on each side of your neck.

Carotidynia happens when the carotid artery is painful and tender. It’s a rare condition that can cause pain in front of the neck.

Scientists don’t fully understand what causes carotidynia. However, the condition has been associated with:

  • taking certain drugs
  • viral infections
  • chemotherapy
  • migraine

Other possible symptoms include:

  • throbbing over the carotid artery
  • tenderness
  • ear pain
  • pain when chewing or swallowing
  • difficulty turning your head

Glossopharyngeal Neuralgia (GPN)

What is glossopharyngeal neuralgia (GPN)?

Glossopharyngeal neuralgia (GPN) is a rare condition that can cause sharp, stabbing, or shooting pain in the throat area near the tonsils, the back of the tongue or the middle ear.

The pain occurs along the pathway of the glossopharyngeal nerve, which is located deep in the neck. It serves the back of the tongue, throat and the parotid gland (one of the salivary glands), the middle ear and eustachian tube.

Painful episodes are usually intermittent, lasting from a few seconds to a few minutes. The pain might recur several times in a day. In other cases it might not come back for several weeks or months.

Certain activities may trigger painful episodes, including:

  • Drinking cold liquids
  • Chewing
  • Swallowing
  • Sneezing or coughing
  • Clearing the throat
  • Touching the gums

Sometimes people with this condition may avoid eating, drinking or chewing because they fear that these activities may trigger a painful attack. Over time, this can result in weight loss.

Generally, only one side of the head is affected by GPN. The glossopharyngeal nerve has several branches, including the tympanic branch that receives sensations from the middle ear and mastoid.

Another important branch is the carotid sinus nerve that serves the carotid body and carotid sinus (widening of a carotid artery at the main branch point). Painful attacks may result in life-threatening symptoms, such as fainting (syncope), slow heartbeat (bradycardia) or arrhythmia (irregular heartbeat). In very rare cases, cardiac arrest may occur with no painful episodes.

How common is glossopharyngeal neuralgia (GPN)?

The disorder is rare, with less than 1 case reported per year among 100,000 people in the United States. It tends to occur more often in adults over age 40, but it may be present at any age. It appears to affect men more than women.

What causes glossopharyngeal neuralgia (GPN)?

Often there is no apparent cause for the condition. Compression of the glossopharyngeal nerve by a blood vessel near the brainstem may irritate the nerve and cause pain. In other cases, an elongated styloid process (a bone in the neck near the nerve) can cause pain. This condition is called Eagle syndrome.

Trauma due to an injury or a surgical procedure may also result in glossopharyngeal neuralgia. Other possible causes include infections, tumors and vascular abnormalities. Patients with multiple sclerosis may experience glossopharyngeal neuralgia as a result of the breakdown of the myelin sheath, the fatty membrane that surrounds and insulates the nerve.

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Sore throat

Sore throats are not usually serious and often pass in three to seven days. There are some treatments you can use at home to relieve your symptoms.

When to see your GP

You should see your GP if you:

  • fall into one of the groups of people at risk of developing complications – this includes anyone with a weakened immune system due to medication, or a condition such as HIV
  • have persistent symptoms that are not improving or responding to self-care

Visit your nearest accident and emergency department (A&E) or call 999 for an ambulance if you have severe symptoms such as:

  • difficulty breathing or swallowing
  • severe pain
  • drooling
  • a muffled voice
  • a high-pitched sound as you breathe (stridor)

Read more about when to visit your GP.

Painkillers

For treating sore throats, over-the-counter painkillers, such as paracetamol, are usually recommended. These may also help reduce a high temperature (fever).

You should not take aspirin or ibuprofen if you have:

  • asthma
  • current or past stomach problems, such as a stomach ulcer
  • current or past liver or kidney problems

Children under the age of 16 should never be given aspirin.

Take painkillers as necessary to relieve your pain. Always read the manufacturer’s instructions so you do not exceed the recommended or prescribed dose.

Self-care tips

If you or someone in your family has a sore throat, the tips below may help relieve the symptoms:

  • avoid food or drink that is too hot, as this could irritate the throat
  • eat cool, soft food and drink cool or warm liquids
  • adults and older children can suck lozenges, hard sweets, ice cubes or ice lollies
  • avoid smoking and smoky environments
  • regularly gargling with a mouthwash of warm, salty water may help reduce swelling or pain
  • drink enough fluids, especially if you have a fever

Steam inhalation is not recommended, as it’s unlikely to help a sore throat and there is a risk of scalding.

Antibiotics

The use of antibiotics is not usually recommended for treating sore throats. This is because most sore throats are not caused by bacteria.

Even if your sore throat is caused by bacteria, antibiotics have very little effect on the severity of the symptoms and how long they last, and may cause unpleasant side effects.

Overusing antibiotics to treat minor ailments can also make them less effective in the treatment of life-threatening conditions. This is known as antibiotic resistance.

Antibiotics are usually only prescribed if:

  • your sore throat is particularly severe
  • you are at increased risk of a severe infection – for example because you have a weakened immune system due to HIV or diabetes (a long-term condition caused by too much glucose in the blood)
  • you are at risk of having a weakened immune system – there are some medications that can cause this, such as carbimazole (to treat an overactive thyroid gland)
  • you have a history of rheumatic fever (a condition that can cause widespread inflammation throughout the body)
  • you have valvular heart disease (a disease affecting the valves in your heart, which control blood flow)
  • you experience repeated infections caused by the group A streptococcus bacteria

Delayed antibiotics prescription

If your GP thinks you might need antibiotics, they may issue a prescription but ask you to wait up to three days for symptoms to improve.

If your sore throat gets worse, or has not improved after three days, you should have instructions to either:

  • take your prescription slip to a pharmacy
  • return to the GP surgery after three days to collect your medication

Recent studies show that complications of a sore throat are uncommon and usually not serious. A delayed antibiotic prescription seems to be as effective as an immediate prescription in reducing complications.

Using a delayed prescription provides similar benefits to an immediate prescription. Most importantly, this helps you to avoid taking antibiotics when they’re not needed and helps prevent antibiotic resistance.

Tonsillectomy

A tonsillectomy is a surgical procedure to remove the tonsils (the two lumps of tissue on either side of your throat). If your child has repeated infections of the tonsils (tonsillitis), a tonsillectomy may be considered.

Read more about treating tonsillitis.

Persistent sore throat

If you have a persistent sore throat (one that lasts three to four weeks), your GP may refer you for further tests. This is because your sore throat may be a symptom of a more serious condition. Some possibilities are described below.

Glandular fever

If you are 15-25 years of age with a persistent sore throat, you may have glandular fever (also known as infectious mononucleosis, or mono). This is a type of viral infection with symptoms that can last up to six weeks.

A persistent sore throat can also be a symptom of some types of cancer, such as throat cancer. This type of cancer is rare and mainly affects people over the age of 50. In the UK every year, 5,300 people are diagnosed with cancer of the oropharynx (the area at the back of your throat) or mouth.

Read more about mouth cancer

Non-infectious causes

In some cases, a sore throat may be caused by substances that irritate the throat. Sources can include:

  • alcohol
  • cigarette smoke
  • an allergy – such as hay fever
  • gastro-oesophageal reflux disease (GORD) – when stomach acid leaks out of the stomach and into the gullet

You may find that avoiding these substances, or seeking treatment for an allergy or GORD, can help to reduce symptoms of a sore throat.

Giving up smoking

If you smoke, giving up will reduce irritation to your throat and strengthen your defences against infection.

The Quit Your Way Scotland service can offer you advice and encouragement to help you quit smoking. Phone Quit Your Way Scotland free on 0800 84 84 84 (8.00am to 10.00pm, every day).

Your GP or pharmacist will also be able to give you help and advice about giving up smoking, or you can read more about quitting smoking.

Preventing a sore throat

As sore throats are caused by bacterial or viral infections, they can be difficult to prevent.

If you have a sore throat caused by an infection, you can help prevent the infection spreading by practising good hygiene, such as washing your hands regularly and keeping surfaces clean and free of germs.

Head and neck cancer

Head and neck cancer symptoms

The ears, nose and throat are the most common areas affected by head and neck cancers. Symptoms of this cancer may depend on where the cancer develops and how it spreads.

For example, tumors in the larynx or pharynx may be discovered as a lump in the throat. Cancer in the mouth may cause sores in the mouth or swelling of the jaw.

In addition to physical signs of head and neck cancer, these tumors often cause symptoms that are similar to less serious conditions, like the common cold. Changes in voice, headaches, sore throat or a cough may be symptoms of throat cancer. Pain or ringing in the ears may also accompany certain head and neck cancers.

Some common symptoms of head and neck cancer tumors include:

  • A lump in the nose, neck or throat, with or without pain
  • A persistent sore throat
  • Trouble swallowing (dysphagia)
  • Unexplained weight loss
  • Frequent coughing
  • Change in voice or hoarseness
  • Ear pain or trouble hearing
  • Headaches
  • A red or white patch in the mouth
  • Bad breath that’s unexplained by hygiene
  • Nasal obstruction or persistent congestion
  • Frequent nose bleeds or unusual discharge
  • Trouble breathing

Learn about treatments for head and neck cancer

Next topic: What are the types of head and neck cancer?

Signs and Symptoms of Laryngeal and Hypopharyngeal Cancers

In most cases, laryngeal and hypopharyngeal cancers are found because of the symptoms they cause.

Hoarseness or voice changes

Laryngeal cancers that form on the vocal cords (glottis) often cause hoarseness or a change in the voice. This can lead to them being found at a very early stage. People who have voice changes (like hoarseness) that do not improve within 2 weeks should see their health care provider right away.

For cancers that don’t start on the vocal cords, hoarseness occurs only after these cancers reach a later stage or have spread to the vocal cords. These cancers are sometimes not found until they have spread to the lymph nodes and the person notices a growing mass in the neck.

Other symptoms

Cancers that start in the area of the larynx above the vocal cords (supraglottis), the area below the vocal cords (subglottis), or the hypopharynx do not usually cause voice changes, and are therefore more often found at later stages.

Symptoms of these cancers may include:

  • A sore throat that does not go away
  • Constant coughing
  • Pain when swallowing
  • Trouble swallowing
  • Ear pain
  • Trouble breathing
  • Weight loss
  • A lump or mass in the neck (due to spread of the cancer to nearby lymph nodes)

Many of these symptoms are more likely to be caused by conditions other than laryngeal or hypopharyngeal cancer. Still, if you have any of these symptoms, it is very important to have them checked by a doctor so that the cause can be found and treated, if needed.

Laryngology

What is laryngology?

Laryngology is a subspecialty within otolaryngology (ear, nose, and throat) that deals with illnesses and injuries of the larynx, often called the voice box. The voice box sits in the front of the neck and contains the vocal cords. The larynx is responsible for sound production and swallowing. It is also the entrance to the windpipe, and therefore plays a critical role in the airway.

What does a laryngologist do?

A laryngologist is a surgeon with a special interest in voice, airway, and swallowing disorders involving the voice box and the throat.

What are some of the diseases that affect the larynx?

There are many conditions that can affect the larynx, including:

  • Benign (non-cancerous) vocal cord lesions.
  • Cancerous or precancerous lesions.
  • Infectious or inflammatory conditions.
  • Autoimmune conditions.
  • Neurologic conditions.
  • Airway conditions.
  • Vocal cord motion abnormalities.

What other factors can affect the larynx?

The vocal cords can also be affected because of other surgical procedures, such as thyroid, cardiac, thoracic, spine, and vascular surgery. Placement of a breathing tube during anesthesia or hospitalization can also sometimes be related to problems in the larynx.

There are several benign vocal cord conditions caused by vocal abuse, misuse, and overuse. Several disorders of the larynx can be caused by strain or injury to the vocal cords through excessive talking, throat clearing, coughing, smoking, screaming, singing, or speaking too loudly or too low.

Eventually, frequent vocal abuse and misuse can cause changes in vocal function and result in hoarseness. (Hoarseness that lasts longer than 2-4 weeks without explanation should be evaluated by an otolaryngologist.)

Disorders caused by abuse, misuse, or overuse include:

  • Laryngitis: An inflammation or swelling of the vocal cords.
  • Vocal cord nodules: Small, benign, callus-like, inflammatory lesions on the vocal cords. Nodules are among the most common noncancerous vocal lesions. Professional singers and people who have a lot of vocal demands (salespersons, teachers) are often at greatest risk for development of these lesions.
  • Vocal cord polyps: These vocal cord lesions are typically post-traumatic (caused by an injury) or inflammatory in nature. They result from a vocal cord injury from heavy vocal demand or persistent coughing. Patients who smoke also have a tendency to develop polyp-like changes on the vocal cords.
  • Vocal cord hemorrhage: A sudden loss of voice, usually due to screaming, shouting, or other strenuous vocal tasks. In a hemorrhage, one or more of the blood vessels on the surface of the vocal cord rupture, and the soft tissues of the vocal cord fill with blood. It is treated with voice rest until the hemorrhage resolves.
  • Professional voice disorders: While this title implies that a person must be a professional speaker or singer, anyone who uses their voice for work is really a professional voice user. Professions that are at especially high risk include teachers, counselors, customer service representatives, and sales representatives.
  • Spasmodic dysphonia: This is a rare neurologic condition of the larynx that involves the involuntary muscle contraction (tightening) of specific muscles within the vocal cords or larynx. This results in a voice that is strained or strangled or intermittently breathy. This is difficult to diagnose for most non-specially trained clinicians and is best treated in a tertiary care voice center.
  • Laryngeal papillomatosis: This is a chronic (long-lasting) viral infection in which benign, wart-like tumors grow inside the larynx or vocal cords, or the respiratory tract leading from the nose into the lungs. The lesions, which are caused by the human papilloma virus (HPV), may grow very quickly and frequently reappear despite sustained treatment. This may cause breathing problems if the patient’s airway is blocked or, more frequently, hoarseness if the lesions are on the vocal folds. Laryngeal papillomatosis can affect adults, children, and infants.
  • Vocal cord paralysis or vocal cord hypomobility: This condition occurs when one or both of the vocal cords in the larynx do not open or close properly. Vocal cords enable people to talk when air held in the lungs is released and passes through the cords, causing them to vibrate and make sounds. In addition to affecting speech, vocal cord paralysis can cause coughing, a feeling of phlegm in the throat, difficulty swallowing, and shortness of breath while talking. Although the main symptom tends to be a breathy and weak voice, symptoms of vocal cord paralysis can be more significant.
  • Vocal cord motion disorders: These can be caused by surgery to the thyroid gland, vascular surgery, thoracic surgery, spine surgery, prolonged or traumatic placement of a breathing tube, or a viral infection.
  • Laryngopharyngeal reflux (LPR): This condition is also called heartburn, acid reflux disease, or gastroesophageal reflux disease (GERD). Gastroesophageal reflux is a burning sensation in the chest that may occur after eating, bending, stretching, exercising, and lying down. GERD occurs when the contents of the stomach travel back up into the esophagus. This can happen when the lower esophageal sphincter (LES) valve, which controls the passage of food from the esophagus to the stomach, fails to close correctly. This condition has more classic heartburn symptoms. Reflux can affect the larynx and cause more atypical symptoms such as coughing, hoarseness, inflammation, and sore throat. In these cases, it is referred to as laryngopharyngeal reflux (LPR). LPR may be associated with frequent coughing, throat clearing, excess mucus and phlegm, and the sensation of a lump in the throat.
  • Laryngeal cancer: Though many growths that affect the larynx are non-cancerous, cancerous tumors can also grow in the larynx. The inner walls of the larynx are lined with cells called squamous cells. Almost all laryngeal cancers begin in these cells and are called squamous cell carcinomas. If not caught early, laryngeal cancer can metastasize (spread) to nearby lymph nodes in the neck. Smokers are at higher risk than non-smokers for cancer of the larynx. The risk is even higher for smokers who drink alcohol. Fortunately, if caught early, laryngeal cancer is very treatable.
  • Laryngeal stenosis: This condition is a narrowing of the vocal cord airway, either from scarring or bilateral (two-sided) vocal cord immobility (inability to move) that can cause problems with breathing. It can be caused by a number of conditions, including autoimmune or inflammatory disorders such as polyangiitis with granulomatosis, traumatic injuries from prolonged intubation, iatrogenic conditions (caused by medical treatment) such as thyroid surgery, malignant (cancerous) conditions, progressive neurologic degenerative conditions, or rare viral infections.
  • Dysphagia: People with this condition have difficulty with swallowing. Some people with dysphagia may be unable to swallow solid foods, liquids, or even saliva. This can lead to the patient becoming malnourished, since he or she is unable to take in enough calories. Dysphagia can also lead to serious infections when poor swallowing causes food to get trapped in the lungs or outside the esophagus. Dysphagia happens when the larynx does not close tightly during swallowing and when the pharynx (throat) does not move food to the esophagus in a coordinated or effective way. Dysphagia is often seen in patients who have suffered strokes, but can also occur after neck surgery or after radiation treatments for head and neck cancer. They can also be a significant component of progressive neurologic conditions. Swallowing conditions can be quite complex and typically benefit from a multidisciplinary (team) approach involving otolaryngology, gastroenterology, and speech pathology.

How are diseases of the larynx diagnosed?

Diseases of the larynx are usually diagnosed by a laryngologist or otolaryngologist. He or she will first perform a physical examination which includes a scope or mirror exam to visualize the larynx and throat. Depending on your symptoms, other tests may be needed. These include imaging studies, biopsies, or an additional endoscopic examination.

If your doctor suspects you have vocal cord paralysis, he or she will first confirm the diagnosis with a scope exam. In some situations, the doctor may also order a laryngeal electromyography (LEMG). This test measures the nerve input to the laryngeal muscles, and can help diagnose and predict if you will recover vocal fold function.

How are diseases of the larynx treated?

Treatments for conditions that affect the larynx vary depending on your diagnosis. Treatment for conditions caused by vocal abuse, misuse, or overuse may be as simple as resting the voice. Voice or singing therapy might also be recommended. This is performed by a speech-language pathologist.

Surgery, radiation therapy, chemotherapy, or a combination of these treatments may be used to treat laryngeal cancer. Surgery may also be required to treat nodules, polyps, or cysts. Treatment for conditions of the larynx and vocal cords are highly individual, depending on your condition, age, and profession. Your doctor will take all of these into account to create a personal treatment plan.

What can be done to prevent diseases of the larynx?

Quitting smoking and cutting back on drinking alcohol can help prevent laryngeal cancer.

Taking proper care not to strain the voice through excessive use or misuse can prevent conditions such as polyps and nodules. This is especially important for singers or people such as teachers or lawyers, who spend much of their day speaking. Taking time to rest your voice, maintain physical fitness, and control irritating factors such as allergy or reflux can help a good deal in preventing these conditions.

It is important to note that most conditions affecting the larynx are treatable if you seek medical attention when you first notice your symptoms. Failing to do so may mean permanent damage to the larynx and voice.

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