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Monday, February 21, 2005

AIPG 2003 ENT Cordectomy

Question. 72.
A middle-aged male comes to the outer patient department (OPD) with the only complaint of hoarseness of voice for the past 2 years. he has been a chronic smoker for 30 years. On examination, a reddish area of mucosal irregularity overlying a portion both cords was seen. Management would include all except:
1. Cessation of smoking.
2. Bilateral cordectomy.
3. Microlaryngeal surgery for biopsy.
4. Regular follow-up.
2. Bilateral cordectomy.
Fundamentals of Ear, Nose, Throat and Head and Neck Surgery – S.K.De – 7th Edition Page 441
Diseases of Ear, Nose and Throat. – P.L.Dhingra - 2nd Edition Page 305
The probable diagnosis is Vocal Cord Papilloma or if you give more significance to the history of him being a smoker, then the diagnosis will move towards premalignant lesion
Such a condition is managed by
• Cessation of Smoking
• Microlaryngeal surgery for
o Biopsy
• Follow up
• Radiotherapy if the biopsy turns out to be Malignant
1. Cessation of smoking is a must.
2. Bilateral cordectomy is not needed.
3. Microlaryngeal surgery for biopsy is indicated.
4. Regular follow-up is a must in any case of premalignant lesions.
No question paper will be complete without a question on Neoplasia in ENT (as well as in Ophthal and Ortho), even though the number of questions asked in these subjects are not as high as in Medicine and Surgery. And to score marks in these areas is very simple as the amount to be studied is limited and there is little scope of a controversy arising from these topics
Go through the TNM Stages of the common tumours of ENT

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