470 THE RESPIRATORY SYSTEM. 



Abscesses may form which rupture into the larynx, or they may extend 

 into the neck or the pharynx or ossophagus. 



Tuberculous Laryngitis. This lesion is most frequently associated with 

 pulmonary tuberculosis. Early in the process there is a formation in the 

 submucosa of miliary tubercles together with more or less new small - 

 celled tissue ; with this is a catarrhal inflammation with an exudate of 

 mucus, pus cells, and desquamated epithelium. 



As coagulation necrosis of the subepithelial tubercles occurs, ulcers 

 are formed, often wdth an increase of the catarrhal exudate. The proc- 

 ess may extend so as to involve the walls of the larynx, and necrosis of 

 the cartilages may follow. Adjacent ulcers may become confluent so 

 that considerable areas of the mucous membrane may be destroyed. 



Syphilitic Laryngitis. This form of inflammation may have the ordi- 

 nary characters of an acute or chronic catarrhal inflammation, or it is pro- 

 ductive in character with the formation of new tissue in the stroma of 

 the mucous membrane. This new tissue is principally composed of 

 small cells, which often degenerate and become necrotic. In this way 

 the mucous membrane of the larynx and the tissues beneath are thick- 

 ened in some places and destroyed in others, giving rise to erosions and 

 ulcers. These changes are especially marked in the upper portion of the 

 larynx. If the perichondrium be involved there may be necrosis of the 

 laryngeal cartilages. Owing to the cicatricial contractions of healed 

 syphilitic ulcers there may be great deformity of the larynx. 



Lesions of the trachea are often associated with those of the larynx and 

 are in general similar in character. 



TUMORS OF THE LARYNX AND TRACHEA. 



Retention Cysts of the mucous glands of the larynx may form sacs 

 projecting into its cavity. 



Papilloma, single or multiple, is the most common form of benign 

 tumor of the larynx. It is most frequent upon the vocal cords and is 

 usually associated with chronic inflammation. Fibroma, lipoma, myxoma, 

 and angioma are occasionally met with. Chrondromata grow from the 

 normal cartilages and are usually multiple and sessile. They may pro- 

 ject into the cavity of the larynx. 



Fusiform or spheroidal-celled sarcomata of the larynx have been seen 

 in a considerable number of cases, both in children and in adults. 



Carcinomata, usually the epitheliomatous type, may originate in the 

 larynx, most commonly upon the false vocal cords. But from adjacent 

 structures, usually from the oesophagus, cancer may invade the larynx. 



In the trachea tumors are of rare occurrence, but occasional examples 

 of growths similar to those in the larynx have been found. Tuberculous 

 and otherwise altered bronchial lymph -nodes may by ulcerative processes 

 enter and obstruct the trachea. 



Single or multiple amyloid masses, often associated with cartilage, 

 have been described in the larynx and trachea. ' 



1 See Manage, Virch. Arch., Bd. clix., p. 117, 1900. 



