About The Book

Laryngology: Clinical Reference Guide is a portable reference guide that fills the void of an easy-to-read, concise, but comprehensive book encompassing all aspects of laryngology. Each chapter follows a uniform outline to facilitate quick review of a topic, and the comprehensive nature of each chapter provides depth. This clinically relevant resource is organized into ten sections that are broken down into their most important and fundamental parts by chapter, including the History of Laryngology; Embryology, Anatomy, and Physiology; Evaluation and Physical Examinations; Laryngologic Disorders; Neurolaryngology; Laryngologic Manifestations of Systemic Diseases; Pediatric Laryngology; Surgery; Swallowing Disorders; and Therapy.
As a review book, it is ideal for residents and fellows in training and those preparing for board and in-service training examinations, as well as medical students looking for a “deeper dive” into the world of laryngology. However, it is also excellent for the practitioner who wants to get a succinct update on the latest, cutting-edge knowledge in all areas of laryngology. The information is authored by a collection of “who’s who” in laryngology.
Formatted like the bestselling “Pasha” (Otolaryngology-Head and Neck Surgery) pocket guide, this text provides a condensed amount of high-yield information with a multidisciplinary approach to bring a broad range of insight into complex clinical challenges.

Key Features

  • Contributions by leaders in the field
  • Tabs for each section for quick access
  • Key terms and notes in bold and italics

About The Authors

Justin Ross, DO is an Otolaryngology resident at Philadelphia College of Osteopathic Medicine in collaboration with Dr. Robert Sataloff at Drexel University College of Medicine. He was raised in southern York County, PA and completed his Bachelor of Science in Biology at York College of Pennsylvania. He is the author of several peer-reviewed publications and book chapters, and has now co-edited one book. Dr. Ross’ research interests include treatment of vocal fold scar and the link between hearing loss and dysphonia.  

Haig Panossian, MD attended college and medical school at Boston University. He then completed his otolaryngology residency at the Icahn School of Medicine at Mount Sinai. Dr. Panossian completed his fellowship in Laryngology under the direction of Dr. Robert T. Sataloff at the Drexel University College of Medicine, where Dr. Panossian is Assistant Professor of Otolaryngology – Head and Neck Surgery. He also is currently in private practice in Westlake Village, California.

Mary J. Hawkshaw, BSN, RN, CORLN, has been associated with Dr. Robert Sataloff, Philadelphia Ear, Nose & Throat Associates, and the American Institute for Voice & Ear Research (AIVER) since 1986. She has served as Secretary/Treasurer of AIVER since 1988 and was named Executive Director of AIVER in January 2000. She is Research Professor of Otolaryngology—Head and Neck Surgery at Drexel University College of Medicine. She has served on the Board of Directors of the Voice Foundation since 1990.

Robert Thayer Sataloff, MD, DMA, FACS, is Professor and Chairman in the Department of Otolaryngology—Head and Neck Surgery and Senior Associate Dean for Clinical Academic Specialties at Drexel University College of Medicine. He is also Adjunct Professor in the Department of Otolaryngology—Head and Neck Surgery at Thomas Jefferson University; as well as on the faculty of the Academy of Vocal Arts.


Table of Contents


About the Editors



Part I. History of Laryngology


Chapter 1. History of Laryngology
Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff

Pre-Grecian Civilizations

Greek and Roman Civilizations

Middle Ages

Renaissance to Late 19th Century

20th Century to Present


Part II. Embryology, Anatomy, and Physiology


Chapter 2. Embryology and Development of the Larynx
Haig Panossian, Mary J. Hawkshaw, and Robert T. Sataloff

Stages and Structures of Development

Developmental Anaomalies

Postnatal Development

Chapter 3. Anatomy and Physiology
Justin Ross, Ayman Bodair, Mary J. Hawkshaw, and Robert T. Sataloff

Laryngeal Anatomy (Figure 3–1)

Phonatory Physiology

Esophageal Embryology

Esophageal Anatomy


Part III. Evaluation and Physical Examination


Chapter 4. Patient History and Physical Examination
Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff

Patient History

Common Laryngologic Problems

Laryngeal Examination

Vocal Fold Vibratory Abnormalities

Voice Examination

Swallowing Evaluation (See Chapter 35)


Chapter 5. The Clinical Voice Laboratory
Haig Panossian, Mary J. Hawkshaw, and Robert T. Sataloff

The Purpose of the Clinical Voice Laboratory

The Clinical Assessment and Examination

Objective Voice Analysis


Chapter 6. Laryngeal Electromyography
Haig Panossian, Mary J. Hawkshaw, and Robert T. Sataloff


EMG Examination

Laryngeal EMG


Part IV. Laryngologic Disorders

Chapter 7. Infections and Inflammatory Disorders of the Larynx

Justin Ross, Sammy Othman, Mary J. Hawkshaw, and Robert T. Sataloff


Acute Supraglottitis (Epiglottitis)

Croup (Laryngotracheobronchitis)

Other Infectious Disorders

Fungal Infections


Chapter 8. Non-Neoplastic Structural Abnormalities of the Larynx

Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff

Vocal Nodules

Laryngeal Cysts

Vocal Fold Polyps

Contact Granuloma and Vocal Process Ulcer

Reactive Lesions

Vocal Fold Hemorrhage

Reinke’s Edema

Prolonged Ulcerative Laryngitis

Sulcus Vocalis

Mucosal Bridge

Laryngeal Webs (See Chapter 12)

Bowed Vocal Folds

Arytenoid Dislocation and Subluxation

Chapter 9. Vocal Fold Scar
Arthur Uyesugi and Jaime E. Moore


Anatomy of the Vocal Folds

Clinical Evaluation


Chapter 10. Vocal Fold Injury and Repair
Susan L. Thibeault


Wound Healing

Vocal Fold Manifestations of Injury and Repair

Microarray Analysis of Vocal Fold Wound Healing and Benign Vocal Fold Lesions

Future Directions and Therapeutic Applications

Chapter 11. Laryngotracheal Trauma
Yolanda D. Heman-Ackah


Schaefer Classification System for Severity of Laryngeal Injuries

Adult Framework Injury

Pediatric Framework Injury

Soft Tissue Injuries from Blunt Trauma

Clinical Evaluation of Blunt Trauma

Surgical Exploration and Repair

Penetrating Injuries

Caustic Injuries (See Chapter 31)

Thermal Injuries

Iatrogenic Injuries

Chapter 12. Acquired Glottic Stenosis

Jared M. Goldfarb, Justin Ross, and Joseph R. Spiegel





Chapter 13. Acquired Subglottic Stenosis

Bhavishya S. Clark, Justin Ross, and Michael M. Johns, III


Anatomy and Physiology of the Subglottis


Histology and Pathophysiology

Clinical Evaluation

Grading Systems for SGS

Management Introduction

Medical Management

Endoscopic Repair

Open Repair



Chapter 14. Tracheal Stenosis

Jared M. Goldfarb and Joseph R. Spiegel




Congenital Tracheal Stenosis (CTS)

Acquired Tracheal Stenosis

Differential Diagnosis



Chapter 15. Benign and Premalignant Lesions of the Larynx

Haig Panossian, Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff




Classification Systems of Dysplasia

Carcinoma in Situ (CIS)

Granular Cell Tumor



Cartilaginous Tumors of the Larynx

Laryngeal Schwannoma


Chapter 16. Laryngeal Neoplasia
Travis Weinsheim, Luke J. Pasick, and Christopher E. Fundikowski


Subsites and Boundaries

Tumor Biology and Pathology

Premalignant Lesions (See Table 16–1)

Staging (Based on AJCC 8th edition)

Treatment (See Table 16–2)

Surgical Approaches

Communication After Laryngectomy



Part V. Neurolaryngology

Chapter 17. Laryngeal Neurophysiology

Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff


Motor Function (See Chapter 3)

Sensory Function

Laryngeal Reflexes



Chapter 18. Vocal Fold Paresis and Paralysis

Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff




Bilateral Vocal Fold Paralysis (BVFP)

Pediatric Vocal Fold Paralysis (See Chapter 31)

Chapter 19. Laryngeal Dystonia
Justin Ross and Aaron J. Jaworek


Spasmodic Dysphonia

Other Laryngeal Dystonias

Chapter 20. Neurologic Disorders Affecting Airway and Voice
Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff



Neurologic Disorders


Part VI. Laryngologic Manifestations of Systemic Diseases

Chapter 21. Voice Disorders in the Elderly
Karen M. Kost and Justin Ross


Age-Related Laryngeal Changes

Other Age-Related Changes


Chapter 22. Reflux Disease
Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff


Histology and Pathophysiology

Clinical Evaluation


Complications of Reflux Disease
Reflux in Pediatric Patients

Esophagopharyngeal Reflux

Chapter 23. Thyroid-Related Disorders of the Larynx
Paul M. Papajohn, Nicholas C. Cameron, Mary J. Hawkshaw, and Robert T. Sataloff







Pathologic Disorders of the Thyroid

Surgical Considerations

Treatment of Thyroidectomy-Related Vocal Fold Paresis and Paralysis

Chapter 24. Autoimmune and Rheumatologic Disease

Jason E. Cohn, Jacob Burdett, Mary J. Hawkshaw, and Robert T. Sataloff

Patient Evaluation

Autoimmune/Inflammatory Conditions of the Larynx

Chapter 25. Allergy

Austin T. Baker, Sarah Christine Nyirjesy, Justin Ross, and Brian J. McKinnon

Immunology of the Allergic Response

Allergy Therapies and Treatments

Allergic Rhinitis (AR)

Chronic Rhinosinusitis

Allergy Testing

Allergic Laryngitis


Chapter 26. Respiratory Dysfunction
Haig Panossian, Mary J. Hawkshaw, and Robert T. Sataloff




Chapter 27. Cough and the Unified Airway
Kevin Tie, Kenneth W. Altman, and Rupali N. Shah


Clinical Evaluation

Acute and Subacute Cough

Chronic Cough

Nonasthmatic Inflammatory Airway Disease in Adults

Unexplained Chronic Cough



Chapter 28. Care of the Transgender and Gender Non-Conforming Patient
Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff


Medical and Voice Therapy

Surgical Therapy

Chapter 29. Psychological Dimensions of Voice Disorders
Deborah Caputo Rosen


Voice and Emotion

Body Image/Self Image

Psychological Phases of Vocal Injury

Psychological Responses to Voice Surgery


Psychogenic Dysphonia/Conversion Disorder

Performance Anxiety

Psychoactive Medications (Table 29–1)

Stress Management

Team Treatment of Psychological Dimensions of Voice Disorders

Chapter 30. Laryngology and Medication
Marissa Evarts, Ghiath Alnouri, Mary J. Hawkshaw, and Robert T. Sataloff



Antacids, Anti-secretory, and Prokinetic Agents (See Chapter 22)










Antitussives and Mucolytics


Chemotherapeutic Agents




Mood-Stabilizing Drugs


Oral Rinses

Sprays, Mists, and Inhalants

Herbs and Supplements


Part VII. Pediatric Laryngology

Chapter 31. Pediatric Laryngology

Marissa Evarts, David J. Lafferty, Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff


Disorders of Pediatric Airway and Voice

Congenital Anomalies of Larynx and Trachea

Pediatric Tracheal Anomalies

Vascular Rings

Management of Foreign Bodies

Acute Airway Obstruction (AAO)

Chronic Airway Obstruction

Traumatic Injuries to Larynx, Trachea, Esophagus, and Neck

Neoplasms of Larynx and Trachea

Pediatric Gastroesophageal Reflux and Laryngopharyngeal Reflux

Caustic Ingestion

Laundry Detergent Pod Ingestion


Part VIII. Surgery

Chapter 32. Laryngeal Laser Surgery
Haig Panossian and Peak Woo

            Laser Physics

            Laser Tissue Interactions

Chapter 33. Voice Surgery

Haig Panossian, Mary J. Hawkshaw, and Robert T. Sataloff

Direct Laryngoscopy

Microsurgical Techniques

Management of Vocal Fold Paresis/Paralysis

In-Office Procedures

Postoperative Voice Care

Chapter 34. Surgical Airway
Harleen Sethi, Justin Ross, Mary J. Hawkshaw, and Robert T. Sataloff


Percutaneous Needle Cricothyroidotomy

Open Tracheotomy

Tracheotomy Care and Management Options


Percutaneous Tracheotomy


Part IX. Swallowing Disorders

Chapter 35. Dysphagia
Jonathan Aaron Harounian and Nausheen Jamal


Phases of Normal Swallowing

Evaluation of Dysphagia

Etiology and Treatment

Swallow Rehabilitation Strategies


Chapter 36. Esophageal Motility, Stenosis and Achalasia
Andrew E. Lee, Jennifer M. Schwartz, Katherine L. Tsavaris, and Asyia Ahmad

Esophageal Anatomy

Coordination of Swallowing

High-Resolution Esophageal Manometry

Esophageal Motility Disorders

Other Motility Disorders

Structural Disorders of the Esophagus

Etiologies of Benign Strictures

Schatzki Ring

Esophageal Webs

Esophageal Diverticulum

Esophageal Malignancies

Extrinsic Structural Disorders of the Esophagus

List of Abbreviations



Part X. Therapy

Chapter 37. Voice Therapy

Bridget A. Rose and Justin Ross

Speech and Voice Evaluation

Voice Therapy

Voice Therapy for Specific Etiologies

Singing Voice as Rehabilitative Intervention


Chapter 38. Swallow Therapy
Tess T. Andrews

Patient Evaluation

Plan of Care

Swallow Therapy



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