Larynx Intrinsic Muscles Tumors

Larynx intrinsic muscles help control your voice and protect your airway when you swallow. Tumors in these small, delicate muscles are rare, but it is important to understand them because early detection and appropriate treatment can make a significant difference in outcomes. In this guide, you will learn about the anatomy of these muscles, what types of tumors occur, the causes and symptoms you should be aware of, the tests used to diagnose these problems, treatment options (from non-drug strategies to medications and surgeries), and the steps you can take to prevent such tumors.

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Anatomy of the Larynx Intrinsic Muscles

The larynx (voice box) is located in the throat just below the pharynx (the part of your throat behind the mouth and nasal cavity). Inside the larynx, a group of small muscles are responsible for controlling the vocal cords and regulating the passage of air. These muscles are known as the intrinsic muscles of the larynx.

Structure & Location

• Position: They lie entirely within the larynx, attached to the laryngeal cartilages.

• Purpose: They help open and close the airway, adjust tension on the vocal cords, and change pitch and tone when you speak or sing.

Muscle Details

There are six primary intrinsic muscles. Here’s a quick look at each, including their origin (where they start), insertion (where they attach), blood supply, nerve supply, and key functions:

1. Cricothyroid Muscle

   • Origin: Cricoid cartilage (a ring-shaped cartilage at the lower part of the larynx).

   • Insertion: Thyroid cartilage (the larger cartilage that forms the front and sides of the larynx).

   • Blood Supply: Mainly from branches of the superior and inferior thyroid arteries.

   • Nerve Supply: External branch of the superior laryngeal nerve.

   • Functions: Adjusts tension on the vocal cords to help change pitch, especially for higher sounds.

2. Thyroarytenoid Muscle (including the Vocalis Muscle)

   • Origin: Inner surface of the thyroid cartilage.

   • Insertion: Vocal process of the arytenoid cartilage on the back of the larynx.

   • Blood Supply: Superior thyroid artery and other laryngeal branches.

   • Nerve Supply: Recurrent laryngeal nerve.

   • Functions: Relaxes the vocal cords for softer sounds and plays a role in voice modulation.

3. Lateral Cricoarytenoid Muscle

   • Origin: Outer surface of the cricoid cartilage.

   • Insertion: Muscular process of the arytenoid cartilage.

   • Blood Supply: Branches from the inferior thyroid artery.

   • Nerve Supply: Recurrent laryngeal nerve.

   • Functions: Closes the vocal cords by rotating the arytenoid cartilages, ensuring a tight seal of the airway during voice production.

4. Posterior Cricoarytenoid Muscle

   • Origin: Posterior (back) surface of the cricoid cartilage.

   • Insertion: Muscular process of the arytenoid cartilage.

   • Blood Supply: Branches from the inferior thyroid artery.

   • Nerve Supply: Recurrent laryngeal nerve.

   • Functions: The only muscle that opens (abducts) the vocal cords, making it essential for breathing.

5. Interarytenoid Muscle

   • Origin and Insertion: Connects the two arytenoid cartilages together.

   • Blood Supply: Small branches from the thyroid arteries.

   • Nerve Supply: Recurrent laryngeal nerve.

   • Functions: Helps close the gap between the vocal cords, contributing to voice production and airway protection.

6. Vocalis Muscle

   • Location: This is considered part of the thyroarytenoid muscle complex.

   • Functions: Fine-tunes the tension of the vocal cords, which is essential for controlling the nuances of sound.

Blood Supply & Nerve Supply Overview

• Blood Supply: The main blood vessels are the superior and inferior thyroid arteries. These arteries branch off to deliver oxygen-rich blood to the laryngeal structures.

• Nerve Supply: The muscles of the larynx receive signals from the recurrent laryngeal nerve (important for motor control) and the superior laryngeal nerve (important for fine-tuning pitch).

Key Functions of the Larynx Intrinsic Muscles

1. Adjust Vocal Cord Tension: They alter the length and tension of the vocal cords to produce different pitches.

2. Control Glottic Closure: They bring the vocal cords together to protect the airway during swallowing.

3. Facilitate Voice Production: They allow fine adjustments necessary for smooth speaking and singing.

4. Regulate Airflow: By opening and closing the airway, they help control how much air passes through.

5. Aid in Breathing: Some muscles, like the posterior cricoarytenoid, help maintain an open airway.

6. Provide Airway Protection: By coordinating movements during swallowing, they help prevent food or liquids from entering the lungs.

A tumor is an abnormal growth of tissue. Tumors can be either benign (non-cancerous) or malignant (cancerous). In the context of the larynx intrinsic muscles, tumors are rare but can affect voice quality and breathing, depending on their location and size.

Types of Tumors in the Larynx Intrinsic Muscles

Tumors that affect the larynx may arise from the muscle tissue, connective tissue, or nearby structures. Although tumors directly involving only the intrinsic muscles are uncommon, here are some tumor types that may be found in the laryngeal region:

1. Benign Tumors:

   • Vocal Cord Polyps: Small, non-cancerous growths that often result from vocal abuse.

   • Papillomas: Growths caused by viral infections (like the human papillomavirus or HPV) that are usually benign but can recur.

   • Lipomas: Benign fatty tumors that are rare in the larynx.

   • Fibromas: Tumors composed of fibrous tissue that can cause localized thickening.

2. Malignant Tumors:

   • Squamous Cell Carcinoma: The most common form of laryngeal cancer, typically starting in the lining cells of the larynx.

   • Chondrosarcoma: A rare cancer that affects the cartilage, which could secondarily involve adjacent muscle tissue.

   • Sarcomas: Rare cancers that arise from muscle or connective tissue in the region.

   • Adenoid Cystic Carcinoma: Typically affects the minor salivary glands but can sometimes be found in nearby areas of the larynx.

Because of the overlap between structures in the larynx, many tumors may involve more than just the intrinsic muscles. Their management, however, will depend on the type, size, and location of the tumor.

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Causes of Larynx Intrinsic Muscles Tumors

Even though tumors in these muscles are uncommon, several risk factors (or causes) have been identified through evidence-based research. The following are 20 potential causes or risk factors:

1. Tobacco Smoking: One of the highest risk factors for any laryngeal tumor.

2. Excessive Alcohol Consumption: Increases the risk, especially when combined with smoking.

3. Human Papillomavirus (HPV) Infection: Certain strains can increase the risk of benign and malignant tumors.

4. Exposure to Asbestos: Can contribute to the development of throat cancers.

5. Chemical Exposure: Inhalation of industrial chemicals and pollutants.

6. Radiation Exposure: Previous radiation therapy in the neck area can raise the risk.

7. Chronic Laryngitis: Ongoing inflammation of the larynx.

8. Voice Abuse or Overuse: Repeated strain on the vocal cords might contribute to benign growths.

9. Poor Vocal Technique: Can lead to stress on the laryngeal muscles.

10. Environmental Toxins: Long-term exposure to air pollution or volatile substances.

11. Genetic Predisposition: Family history of head and neck cancers.

12. Diet Poor in Antioxidants: Inadequate nutrition might lower protection against cell damage.

13. Gastroesophageal Reflux Disease (GERD): Acid reflux can irritate the larynx tissues.

14. Immunocompromise: A weakened immune system might increase cancer risk.

15. Chronic Infections: Ongoing infections can cause repeated irritation.

16. Poor Oral Hygiene: Related to increased bacterial load and inflammation.

17. Occupational Hazards: Working in industries with inhalable hazardous substances.

18. Advanced Age: Most laryngeal tumors are found in older individuals.

19. Gender: Males are statistically more likely to be affected than females.

20. Previous History of Cancer: Past cancers can increase the risk for developing additional tumors.

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Symptoms

Tumors in the larynx intrinsic muscles can cause a variety of symptoms. Here are 20 common symptoms to look for:

1. Hoarseness or Changes in Voice: A persistent change in voice quality.

2. Loss of Voice: Temporary or long-term inability to speak clearly.

3. Throat Pain or Discomfort: Persistent pain in the throat or laryngeal region.

4. Difficulty Swallowing (Dysphagia): Feeling of food being stuck.

5. Breathing Difficulties: Shortness of breath or noisy breathing.

6. Chronic Cough: A cough that does not go away.

7. Sensation of a Lump in the Throat: Also described as a feeling of fullness.

8. Ear Pain: Referred pain from the larynx to the ear.

9. Unexplained Weight Loss: May signal an underlying malignancy.

10. Blood in the Saliva or Sputum: Presence of blood when coughing up mucus.

11. Persistent Throat Clearing: Continual need to clear the throat.

12. Pain on Swallowing: Discomfort experienced during eating or drinking.

13. Fatigue: General tiredness or low energy.

14. Difficulty Breathing During Exercise: Shortness of breath when active.

15. Chest Pain: May occur if the tumor affects surrounding structures.

16. Voice Fatigue: Voice tiring quickly after speaking.

17. Difficulty with High-Pitched Sounds: Trouble producing high tones.

18. Swelling in the Neck: Lymph node involvement or direct tissue swelling.

19. Stridor: A high-pitched sound when breathing in, indicating airway narrowing.

20. Persistent Infections or Inflammation: Ongoing infections that do not resolve easily.

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Diagnostic Tests

If you experience any of the above symptoms or are at risk due to the causes mentioned, doctors may use the following 20 diagnostic tests to determine whether a larynx tumor is present:

1. Laryngoscopy: A flexible or rigid scope is used to visualize the larynx.

2. Direct Laryngoscopy: Provides a more detailed examination, often under anesthesia.

3. Stroboscopy: A special type of laryngoscopy using strobe lighting to study vocal cord vibrations.

4. Videolaryngostroboscopy: Combines video recording with stroboscopy.

5. CT Scan (Computed Tomography): Cross-sectional images to assess tumor size and spread.

6. MRI (Magnetic Resonance Imaging): Detailed imaging to evaluate soft tissue involvement.

7. Ultrasound: May help evaluate nearby neck structures.

8. Biopsy: Removal of a small tissue sample for laboratory analysis.

9. Fine-Needle Aspiration (FNA): A minimally invasive method to sample tissue from lymph nodes.

10. PET Scan (Positron Emission Tomography): Assesses metabolic activity of the tissue.

11. X-ray: Sometimes used to view bony involvement or overall neck structure.

12. Bronchoscopy: Can be used if the tumor extends to the lower respiratory tract.

13. Blood Tests: To check overall health and look for markers of cancer.

14. Speech and Voice Analysis: Evaluates the impact on voice functions.

15. Endoscopy: Similar to laryngoscopy but may assess further down the airway or esophagus.

16. Immunohistochemistry: Laboratory techniques to determine the tumor type.

17. Molecular Testing: Identifies specific genetic changes in tumor cells.

18. Flow Cytometry: Sometimes used to analyze cell types.

19. Examination under Anesthesia: Allows for a thorough, hands-on examination.

20. Laryngeal EMG (Electromyography): Measures muscle activity to assess nerve function.

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Non-Pharmacological Treatments

There are many non-drug approaches (30 options listed here) that may help manage symptoms, improve quality of life, and even support recovery when combined with other therapies:

1. Voice Therapy: Working with a speech-language pathologist to learn better vocal techniques.

2. Speech Therapy: To help maintain or improve communication skills.

3. Physical Therapy: To strengthen neck muscles and improve posture.

4. Respiratory Therapy: Exercises to improve breathing technique.

5. Dietary Changes: Optimizing nutrition to support the immune system.

6. Lifestyle Modifications: Quitting smoking and reducing alcohol intake.

7. Stress Management: Techniques such as mindfulness meditation and yoga.

8. Behavioral Therapy: Support for managing the emotional impacts of a tumor diagnosis.

9. Vocal Rest: Avoiding overuse of the voice to allow healing.

10. Hydration: Drinking plenty of fluids to keep tissues moist.

11. Avoiding Irritants: Reducing exposure to pollutants and allergens.

12. Environmental Control: Using humidifiers to maintain airway moisture.

13. Acupuncture: May help alleviate pain and improve voice function.

14. Chiropractic Care: To relieve neck tension and improve posture (if appropriate).

15. Nutritional Counseling: Guidance to boost overall health.

16. Psychological Support: Counseling or therapy to address anxiety or depression.

17. Support Groups: Joining others who are facing similar issues.

18. Educational Workshops: Learning about voice care and tumor management.

19. Postural Training: Techniques to maintain a healthy neck alignment.

20. Breathing Exercises: To improve airflow and vocal support.

21. Mindfulness Meditation: Reduces stress and may improve overall well-being.

22. Herbal Supplements: Some use natural supplements (always with medical advice).

23. Biofeedback: A technique that helps control physiological functions.

24. Manual Lymphatic Drainage: May reduce swelling in the neck region.

25. Occupational Therapy: To adjust daily activities to reduce strain.

26. Sound Amplification Devices: For those with mild voice loss.

27. Vocal Warm-Ups: Regular exercises that prepare the voice for use.

28. Energy Conservation Techniques: Strategies to manage fatigue.

29. Patient Education: Empowering the patient with knowledge about their condition.

30. Regular Monitoring: Follow-up visits to track changes and adjust treatment plans.

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Drugs and Pharmacological Treatments

Doctors may recommend medications as part of the overall treatment plan. Here are 20 drugs and classes of drugs that could be used when treating larynx tumors:

1. Cisplatin: A chemotherapy agent used in many head and neck cancers.

2. 5-Fluorouracil (5-FU): Another chemotherapy drug often used in combination.

3. Docetaxel: A taxane-based chemotherapy.

4. Paclitaxel: Similar to docetaxel, used in combination regimens.

5. Cetuximab: A targeted therapy that blocks certain cell receptors.

6. Pembrolizumab: An immunotherapy drug that helps the immune system attack cancer cells.

7. Nivolumab: Another immunotherapy option.

8. Erlotinib: A targeted therapy for certain types of cancer cells.

9. Methotrexate: Used occasionally in head and neck cancers.

10. Bleomycin: Part of combination chemotherapy regimens.

11. Vincristine: A chemotherapy drug that can be used in select cases.

12. Ifosfamide: Sometimes used for sarcomas.

13. Temozolomide: In select protocols for tumor reduction.

14. Analgesics (e.g., Acetaminophen): For pain management.

15. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): To reduce inflammation and pain.

16. Corticosteroids (e.g., Prednisone): To reduce swelling and inflammation.

17. Antiemetic Drugs (e.g., Ondansetron): To manage nausea from chemotherapy.

18. Antibiotics: For secondary infections if they occur.

19. Laryngopharyngeal Reflux Inhibitors (e.g., Proton Pump Inhibitors): To manage acid reflux that might irritate the larynx.

20. Supportive Medications: Supplements or growth factors that help manage side effects of treatment.

Note: The exact drug regimen will depend on your particular diagnosis, tumor type, and overall health. Treatment plans are best determined by your healthcare team.

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Surgical Treatment Options

When medications and non-pharmacological treatments do not suffice, surgery may be required. Here are 10 surgeries that may be considered for larynx tumors or tumors affecting the intrinsic muscles:

1. Transoral Laser Microsurgery (TLM): Minimally invasive removal of small tumors using a laser.

2. Partial Laryngectomy: Removal of part of the larynx, preserving some voice function.

3. Total Laryngectomy: Complete removal of the larynx, often required for extensive or malignant tumors.

4. Neck Dissection: Removal of lymph nodes if the tumor has spread.

5. Endoscopic Resection: Removal of the tumor using an endoscope.

6. Open Surgical Resection: A traditional approach for larger or more complex tumors.

7. Robotic-Assisted Surgery: Advanced minimally invasive techniques for better precision.

8. Microflap Surgery: A delicate procedure for removing small benign lesions.

9. Reconstructive Surgery: Procedures to restore voice function after tumor removal.

10. Tracheostomy: Creating an opening in the neck to secure the airway, sometimes temporarily used before or after other surgeries.

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Prevention Strategies

Preventing larynx tumors involves reducing risk factors and regularly monitoring your health. Here are 10 strategies you can follow:

1. Quit Smoking: Stop smoking and avoid exposure to secondhand smoke.

2. Limit Alcohol Consumption: Drink alcohol in moderation or avoid it completely.

3. Practice Good Oral Hygiene: Keep your mouth and throat healthy.

4. Avoid Environmental Pollutants: Use protective equipment if you work in polluted environments.

5. Maintain a Healthy Diet: Eat plenty of fruits and vegetables rich in antioxidants.

6. Stay Hydrated: Drink enough water to keep your tissues well-lubricated.

7. Manage Acid Reflux: Treat GERD to prevent irritation of the larynx.

8. Regular Check-ups: See your doctor regularly for examinations.

9. Vaccination: Consider vaccination against HPV when recommended.

10. Protect Yourself at Work: Follow safety guidelines if exposed to chemicals or other hazards.

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When to See a Doctor

Early detection is key to successful treatment. You should contact your healthcare provider if you experience any of the following:

• A persistent hoarse or changed voice lasting more than 2-3 weeks.

• Difficulty swallowing or feeling of a lump in your throat.

• Unexplained weight loss or persistent throat pain.

• Breathing difficulties or noisy breathing (stridor).

• Any new symptoms that worry you or do not improve with time.

Your doctor may refer you to an ear, nose, and throat (ENT) specialist for a thorough examination if these symptoms develop.

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Frequently Asked Questions (FAQs)

Here are 15 common questions and their plain English answers:

1. What exactly are larynx intrinsic muscles?
   They are small muscles inside your voice box that control your vocal cords and help you speak and breathe.

2. What causes tumors in the larynx?
   Tumors may develop due to long-term irritation (from smoking or acid reflux), infections (like HPV), environmental toxins, genetic predisposition, and other factors.

3. Are all larynx tumors cancer?
   No, many tumors in the larynx are benign (non-cancerous), but some, such as squamous cell carcinomas, are malignant.

4. How do tumors in the larynx affect my voice?
   They can cause hoarseness, a change in pitch, or even loss of voice because they interfere with the delicate muscle movements that create sound.

5. What symptoms should prompt me to see a doctor?
   Persistent voice changes, throat pain, difficulty swallowing, breathing problems, and any unexplained symptoms affecting your throat or neck.

6. How are these tumors diagnosed?
   Doctors use a combination of voice examinations, laryngoscopy, imaging (CT/MRI), biopsies, and other tests to diagnose the condition.

7. Is surgery always required?
   Not always. Treatment depends on the size and type of tumor. Some benign tumors are managed with voice therapy or minimally invasive procedures.

8. What non-drug treatments can help?
   Voice therapy, breathing exercises, stress management, and lifestyle modifications such as quitting smoking can all help manage symptoms and support recovery.

9. How successful are treatments for laryngeal tumors?
   Early detection and appropriate treatment (whether surgery, drugs, or therapy) usually lead to better outcomes. The success depends on the tumor type and stage.

10. Can I recover my voice after treatment?
    Many patients experience improvement or restoration of their voice, especially with voice therapy post-treatment. However, results depend on the type and extent of surgery or treatment.

11. What risk factors can I control?
    You can reduce your risk by avoiding smoking, limiting alcohol, maintaining good diet and hydration, and managing acid reflux.

12. How does HPV increase the risk?
    Certain strains of HPV can cause cell changes in the throat that may lead to benign growths (papillomas) or in rare cases, cancers.

13. What kinds of medications are used?
    Treatments can include various chemotherapy agents, targeted therapies, immunotherapies, as well as supportive drugs for pain and inflammation.

14. How often should I have my throat checked if I’m at risk?
    If you have risk factors or persistent symptoms, an annual examination or earlier follow-up is recommended by your healthcare provider.

15. Are there lifestyle changes that can help prevent recurrence?
    Yes. Quitting smoking, reducing alcohol intake, improving nutrition, and regular follow-ups can help lower the chance of recurrence or the development of new problems.

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Final Thoughts

Tumors involving the larynx intrinsic muscles may sound complex, but understanding them in simple terms can help you make informed decisions about your health.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members

Last Update: April 07, 2025.

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