The narrowing or stricture of the larynx. It also may be referred to as a laryngostenosis. The larynx is the muscular, cartilaginous organ at the upper end of the trachea below the end of the tongue. The larynx is a part of the airway and the organ of voice.

An abscess, tumor, or goiter may cause stricture or stenosis of the larynx. It also may be caused by congenital membranes, foreign bodies, scar contractions following ulcerations from diphtheria and tertiary syphilis, penetrating wounds, or corrosive fluids.

Dyspnea on inspiration and exertion; stridulous choking-type respiration; weak, rapid pulse; and an anxious, cyanotic face are the signs and symptoms seen in laryngostenosis. There may also be changes in voice sounds.

Laryngoscopy, computed tomography (CT) scan, x-rays, bronchoscopy, and esophagoscopy are tests used to determine the extent of the stenosis. Pulmonary function tests show the distinctive pattern of volume-dependent airway obstruction on the flow-volume loop. Obstruction is usually considered present when the forced expiratory volume in one second (FEV-1) is less than 80% of the predicted value.

Underlying causes are the focus of treatment; the treatment depends on the severity of the stenosis. The initial treatment is to reduce dyspnea. Emergency tracheotomy or cricothyrotomy may be required. If the stenosis is extensive, a permanent tracheostomy, resulting in a laryngeal stoma, may be required. Other treatment goals include a diet of soft foods to maintain adequate nutrition. If voice sounds are impaired, artificial speech with esophageal speech therapy may be required.

There may be a laryngeal stoma, loss of speech sounds, and changes in body image, swallowing and eating.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• Or evaluate as aphonia (Diagnostic Code 6519). (38 CFR §4.97 [Schedule of ratings-respiratory])

• Consider entitlement to special monthly compensation under 38 U.S.C. 1114, subsection (k) and 38 CFR 3.350 (a) based on complete organic aphonia with constant inability to communicate by speech.