LEGAL ISSUES IN INFLAMMATORY DISORDERS OF THE LARYNX
In chronic laryngitis the important issue is the distinction of inflammation from a cancer which causes hoarseness. In general practice it is mandatory for anyone with persisting hoarseness which lasts for more than 3-6 weeks to be referred for specialist examination of the vocal cords. Failure to do this represents an unsatisfactory standard of practice, and this is generally accepted by experts in general practice. Only the experienced laryngologist has the skills to visualise the vocal cords and to exclude a tumour, and it still unfortunately happens that patients arrive in the ENT clinic with an advanced laryngeal cancer and a history of hoarseness going back many months, which has been attributed to inflammation, vocal strain or nervous shock following an adverse life event. Legal actions arising from late diagnosis of laryngeal cancer are not particularly common, but there would certainly be scope for a successful action if, for example, long delay had been followed by a requirement for a major operation on the throat rather than radiotherapy which could have been applied at an earlier stage of a tumour’s evolution. The same would apply to a cancer presenting at an incurable stage following long delay in diagnosis. There may, however, be difficulty in establishing the likely stage of a tumour at the time of presentation to a GP.