Question: An 83 year old male undergoes a total laryngectomy for a T3N2bM0 SCC of the glottis. He refuses adjuvant radiation therapy. Nine months later, the patient is referred back to you for an ill-fitting laryngectomy tube. There is heaped up reddish tissue around the stoma that bleeds easily. What is your next step in management?

a) Silver nitrate cautery and refitting of laryngectomy tube

b) Balloon dilation

c) Injection of triamcinolone for suspected granuloma

d) Biopsy

[Answer will be posted with next week's new question]

Answer to last week's question, “Drain Clog” (August 2, 2021)

A - Otic hydrocephalus.