Laryngeal Cancer

In 90% of cases are in laryngeal cancer is a squamous cell carcinoma. Smoking, alcohol abuse, low socioeconomic status, male sex, and age> 60 years increases the risk. Since early developed hoarseness, vocal cord tumors are often diagnosed early. However, supraglottic tumors manifest (above the vocal cords) and subglottic tumors (below the vocal cords) is often in an advanced stage, since they can remain asymptomatic for a long period of time. The diagnosis is based on Laryngoskopie- and biopsy findings. The treatment of tumors at an early stage is to surgery or radiation. Tumors in advanced stages are often treated with chemotherapy and radiotherapy. An operation is provided for salvage therapy or in lesions with extension extralaryngealer or cartilage destruction. After total laryngectomy, the ability to speak must be restored.

Squamous is the most common laryngeal tumor. In the US, because men and people become ill four times more common with low socioeconomic status. About 95% of patients are smokers; for smokers (1 pack / day) increases the risk after 15 years on 30 times. The incidence of laryngeal cancer is approximately 14,000 new cases per year and is declining, especially in men, probably because of changes in smoking habits. Annual deaths are about 3600th

In 90% of cases are in laryngeal cancer is a squamous cell carcinoma. Smoking, alcohol abuse, low socioeconomic status, male sex, and age> 60 years increases the risk. Since early developed hoarseness, vocal cord tumors are often diagnosed early. However, supraglottic tumors manifest (above the vocal cords) and subglottic tumors (below the vocal cords) is often in an advanced stage, since they can remain asymptomatic for a long period of time. The diagnosis is based on Laryngoskopie- and biopsy findings. The treatment of tumors at an early stage is to surgery or radiation. Tumors in advanced stages are often treated with chemotherapy and radiotherapy. An operation is provided for salvage therapy or in lesions with extension extralaryngealer or cartilage destruction. After total laryngectomy, the ability to speak must be restored. Squamous is the most common laryngeal tumor. In the US, because men and people become ill four times more common with low socioeconomic status. About 95% of patients are smokers; for smokers (1 pack / day) increases the risk after 15 years on 30 times. The incidence of laryngeal cancer is approximately 14,000 new cases per year and is declining, especially in men, probably because of changes in smoking habits. Annual deaths are about 3600. 60% of patients are still in a localized stage of the disease to the doctor, 25% have not only the local tumor regional lymph node metastases and 15% present at an advanced stage of the disease with / without distant metastases before. Lymph node metastases are more frequent than glottic cancers due to the minimal lymphatic drainage of the glottis in supraglottic and subglottic tumors. Distant metastases occur in the lungs and liver most often. The primary tumor is often located on the vocal folds (glottis) and supraglottic larynx on. The rarest localization is the subglottic larynx, from which emanate only 1% of the primary tumors of the larynx. The verrucous carcinoma, a rare variant of squamous, usually arises in the glottis and has a better survival rate than the usual squamous cell carcinoma. Symptoms and discomfort symptoms and complaints are different depending on the involved part of the larynx. Hoarseness is a common early symptom of tumors in the glottis, however, is a late symptom in supraglottic and subglottic tumors. Patients with subglottic cancer often present with an airway obstruction. Hoarseness is a common symptom in the later stages. Patients with supraglottic cancer often present with dysphagia. Other common symptoms include airway obstruction, ear pain, development of a neck mass or a “Hot Potato Voice”. Patients with these symptoms should be referred immediately to a direct laryngoscopy. Diagnostic laryngoscopy Operative endoscopy and biopsy Imaging tests for staging all patients presenting hoarseness for> 2-3 weeks should be examined her throat by a specialist. Some practitioners use a mirror to assess the larynx, but most prefer a flexible fiber-examination. All detected lesions require further investigation, usually with surgical endoscopy and biopsy, while clarifying the upper respiratory tract and gastrointestinal tract to second primaries. The incidence of simultaneous second primary tumor can be up to 10%. In patients with confirmed carcinoma usually a CT of the neck with contrast agent and a chest X-ray or a chest CT is performed. Most doctors have a PET of the neck and thorax perform at the time of diagnosis. Forecast Glottisches cancer at an early stage has a 5-year survival rate of 85 to 95%. The 5-year survival rate of patients with cancer of the larynx is a total of about 60%. Patients with regional lymph node involvement have a 43% 5-year survival rate, and those with distant metastases have a 30% 5-year survival rate. Therapy early (T1 and T2): surgery or radiotherapy Moderate advanced stage (T3): radiotherapy and sometimes chemotherapy advanced (T4): surgery (often followed by radiation therapy and sometimes chemotherapy) or sometimes chemotherapy and radiotherapy A Glottiskarzinom at an early stage (see Table : staging of head and neck tumors) is treated with Laserexzision, radiotherapy or occasionally open surgery the larynx. In endoscopic laser resection and radiotherapy normal speech function is usually obtained and it can be achieved similar cure rates. Whether surgery or radiation therapy is used for the treatment of a glottal tumors at an early stage, depends generally on the preferences of the treatment device and the patient. In a Glottiskarzinom advanced stage, defined by a lack of vocal fold mobility or expansion on the tongue, most patients are treated with both chemotherapy and radiation therapy. If the patient presents with an extension outside of the larynx or with a cartilage invasion, a laryngectomy offers the best oncologic results; laryngectomy is usually completely, but an endoscopic laser resection or open partial laryngectomy can be used in appropriate cases selected. A complete laryngectomy is often used in emergency situations; However, endoscopic resection or open partial laryngectomy can sometimes be used in these situations. Supraglottic early cancers can be successfully treated or treated by partial laryngectomy. The laser resection has shown considerable success in supraglottic squamous Frühstatium and minimizes the functional changes operationem post. If an advanced cancer has not spread to the vocal cords, a laser resection or open partial supraglottic laryngectomy can be performed to obtain the vote and sphincter function of the larynx. If the vocal cords are affected, a supracricoide laryngectomy or total laryngectomy is required unless the decision is made for an operation. As with most Glottiskarzinom supraglottic tumors in advanced stages are first treated with chemotherapy and radiotherapy. The supraglottis has a rich lymphatic network so that the neck has to be considered in all patients with supraglottic cancer. The treatment of hypopharyngeal is similar to that of throat cancer. Early lesions are usually treated with radiation alone, although the endoscopic resection is also an option. However, the majority of patients with hypopharyngeal is due to the silent nature of the disease and the frequent regional lymphatic spread at an advanced stage of the disease; Such patients are treated primarily with chemotherapy and radiation therapy and surgical salvage. Rehabilitation A rehabilitation may be required either surgical or non-surgical treatment. Significant swallowing problems are common after chemotherapy and radiation therapy and may require esophageal dilatation, an oral therapy or, in severe cases, surgical replacement of the pharynx or the diet through a gastrostomy tube. Swallowing is also affected by surgery and may also require you to swallowing therapy or dilation. Speaking, in contrast, significantly more affected by surgery. After a total laryngectomy the patient a tracheoesophageal puncture requires a voice replacement by a Ösophagusmembran an electric larynx (Electrolarynx) For all three methods sounds are using pharynx, palate, tongue, teeth and lips converted to articulate speech. The articulation with the oesophageal done by jerky discharging the drawn-in inspiration into the esophagus air over the pharyngoösophageale connection. The tracheoesophageal puncture includes the placement of a valve between the trachea and esophagus in order to facilitate the formation of sounds. When exhaling air is pressed through the valve into the esophagus, so as to generate sounds. In rehabilitation treatment patients receive in addition to physiotherapy and speech therapy also provides guidelines for the care and proper use of the valve. You must also be aware of the risk of aspiration (solid and liquid food or secretions). An electric larynx (Electrolarynx) consists of a battery-powered sound source which is held for articulation to the neck. Although there is a great social stigma for many patients, this has the advantage that it works right out with little or no training. Important points Hoarseness is a common early symptom of tumors of the glottis, however, is a late symptom in supraglottic and subglottic tumors. All patients who show hoarseness for> 2-3 weeks should be examined her throat by a specialist. In patients with confirmed carcinoma usually a CT of the neck and often PET / CT in advanced stages forge done. The treatment of cancer at an early stage (T1 and T2) consists in surgery or radiation treatment. Moderate advanced cancer (T3) is treated with radiotherapy and sometimes chemotherapy. The treatment of advanced cancer (T4), which propagates outside of the larynx is carried out with surgery and post-operative chemotherapy and radiotherapy.

Health Life Media Team

Leave a Reply