Cancer of the larynx
Cancer of the larynx – Elite Treatment in Europe
ENT Diseases -2005
Of the malignant tumors of the larynx in the first place the cancer (cancer laryngis). Laryngeal cancer primarily affects men between the ages of 40 to 70 years: 100 males accounted for 8 women.
In the etiology of cancer known value attached to a number of diseases of the larynx, which are called precancerous. They are:
- papilloma, long-existing
- leukoplakia of the mucous membrane and its dyskeratosis
- fibroma on the basis of a wide
- branchiogenous and other causes cysts laryngeal ventricles
- chronic inflammatory processes that are not inferior treatment due to syphilis, alcoholism, smoking.
The most significant is a malignancy of papillomas. Intermediate form between precancerous conditions and cancer is the so-called "carcinoma in situ classification of cancer of the larynx allows for a localization, and tumor stage. This is dictated by the peculiarities of the flow depending on the place of defeat, which in turn is explained by the anatomical structure of the larynx, particularly of the lymphatic system.
There are three main larynx:
- The top, or the vestibular, Department of the larynx, which includes, drew its epiglottic ligament with a glottal hand, the false vocal cords and epiglottis morganievy ventricles.
- The average office – part of the true vocal cords.
- The lower, or subglottic, Department of the larynx.
I stage. Tumor or ulcer, limited the mucosa and submucosal layer, and not extending beyond a single department of the larynx.
Stage II. Tumor or ulcer, and limited mucosal and submucosal layer, has a full department of the larynx, but does not go beyond it. The mobility of the larynx is preserved. In the regional areas of metastases is not defined.
- a) the tumor moves to the underlying tissues, causing the immobility of the corresponding half of the larynx, but does not extend beyond any one of the department;
- b) the tumor spread to other parts of the larynx. The presence of single or multiple mobile regional metastases or solitary metastasis limited mobility.
- a) extensive tumor occupying a large part of the larynx with infiltration of the underlying tissues;
- b) tumors that grow in the adjacent organs;
- c) fixed metastases in cervical lymph nodes, and d) tumor of any size in the presence of distant metastases.
Symptomatology of laryngeal cancer depends on the stage and location of it. The tumor on the epiglottis or false vocal cords can be a long time does not manifest itself, for the patient to remain unnoticed. On the contrary, the localization of the true vocal cords are disrupted early in phonation: first tone of voice changes, it becomes rough, and then there is hoarseness. Hoarseness, and often causes the patient to see a doctor.
In the future, to the extent of tumor growth, increased hoarseness, the patient can speak only in whispers. At the same time develop other symptoms – shortness of breath. In advanced stages, pain on swallowing.
In cancer of the epiglottis and the arytenoid cartilage is preceded by a feeling of pain, a feeling of awkwardness or something outside. In the case of the collapse of the tumor and join the secondary perihondrita pain is much worse. After a while there is coughing up blood, choking, difficulty in passing joins the food down the esophagus.
Decaying tumor emits a stench. Patients lose weight, become weak, growing cachexia. Thus, the earliest symptom of laryngeal cancer is most often hoarseness. Since this is a symptom and many other diseases of the larynx, the elucidation of the causes of hoarseness is possible only by laryngoscopy.
Laryngoscopy, especially in the localization of tumors in the true vocal cords, can establish the presence of a tumor, even in cases where the size of no more than small peas. In this way, provided the main conditions to fight the cancer process – early diagnosis.
In the space subligamentous primary cancer is rare, occurs for some time without symptoms and is diagnosed when the leaves are already out of this space. Subsequently, the tumor extends to the true vocal cords, so that there is persistent hoarseness. This symptom is characteristic and appears earlier than the shortness of breath. Lead one to believe there may be a tumor-sided increase of arytenoid cartilage.
It helps to recognize tumor tracheoscopy. In the propagation process of cancer to adjacent organs – the pharynx, the tongue, esophagus – joined by new symptoms: inability to swallow, esophageal obstruction. The state of the esophagus turns through fluoroscopy and esophagoscopy.
The diagnosis of laryngeal cancer confirmed by microscopic examination slices of infiltration. However, if a positive response histologist in this case is crucial, it is usually considered a negative conclusion doubtful.
It so happens that the pathologist sees change as an inflammatory process, and the laryngoscope is determined by the tumor. This discrepancy may be explained by taking a test piece from the surface, a secondary inflammatory process, the simultaneous presence of two diseases such as cancer or cancer and syphilis, and tuberculosis. Sometimes it does not help to clarify the nature of the process and re-biopsy. Special caution should be in cases where the microscopic papilloma diagnosed in older men.
Laryngeal cancer used combined (sequential) treatment: radiation therapy and surgery.
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