Throat cancer

Introduction to laryngeal cancer Laryngeal cancer (carcinomaoflarynx) is a relatively common malignant tumor with an incidence of about 1 to 5% of systemic tumors. It ranks third in the field of otolaryngology, second only to nasopharyngeal carcinoma and sinus cancer. The age of good hair is 50 to 70 years old. Men are more common than women, about 8:1, with the highest incidence in Northeast China, North China and East China. The cause is not well understood, but the patient has a long history of smoking. Live histopathology is the main basis for the diagnosis of laryngeal cancer. Specimen collection can be done under the laryngoscope. Note that the center of the tumor should be clamped and not taken on the ulcer surface because there is necrotic tissue. Some require repeated biopsies to confirm. The biopsy should not be too deep or too deep to avoid bleeding. basic knowledge The proportion of illness: 0.02% Susceptible people: males with a good age of 50 to 70 years old Mode of infection: non-infectious Complications: electrolyte imbalance

Causes of laryngeal cancer

There are no clear causes, but they may be related to the following factors:

(1) Radiation: It can cause cancer when treating neck mass with radiation.

(2) Excessive drinking: long-term stimulation of mucous membranes can cause degeneration and cause cancer.

(3) Chronic inflammatory stimuli such as chronic laryngitis or respiratory tract inflammation.

Smoking (20%):

Tobacco burning can produce tobacco tar, in which benzoquinone can cause cancer, and tobacco smoke can stop or slow cilia movement, also cause mucosal edema and hemorrhage, and make epithelial hyperplasia, thickening, squamous metaplasia, and become the basis of carcinogenesis.

Virus infection (22%):

Viral infection is closely related to the development of cancer. It is generally believed that the virus can change the nature of the cell and cause abnormal division; the virus can be attached to the gene, passed to the next generation cell, and cancerous.

Air pollution (14%):

Harmful gases such as sulfur dioxide and productive industrial dust such as chromium, long-term inhalation of arsenic can cause laryngeal cancer.

Sex hormones (8%):

Related experiments have shown that the percentage of estrogen receptor-positive cells in patients with laryngeal cancer is significantly increased.

Precancerous lesions (8%):

Laryngeal keratosis and benign tumors of the larynx such as laryngeal papilloma can be cancerous.

Laryngeal cancer prevention

Smoke and alcohol should be quit. Long-term hoarseness, sore throat, poor breathing or bloody cough should be alert to laryngeal cancer. Please check with a specialist in time to achieve early detection, early diagnosis and early treatment.

Laryngeal cancer care:

Preoperative care

(1) When there is a sudden local swelling, extremely difficult breathing, pulse increase and other symptoms, you should consider the tumor necrosis and blood pressure to force the trachea, you need to notify the doctor in time, and immediately prepare for treatment.

(2) Those who need radiotherapy or chemotherapy before surgery, according to the radiotherapy and chemotherapy routine.

2, postoperative care

(1) After the patient is awake, take a semi-recumbent position to facilitate breathing and drainage.

(2) Place ice on the neck to prevent bleeding from the incision.

(3) Postoperative release, chemotherapy, according to routine care.

(4) Strengthen psychological care.

Laryngeal cancer complications Complications electrolyte disorder

Complications usually occur after surgery, such as tube blocking, tube removal, aspiration, misplacement, nausea, vomiting, diarrhea, water and electrolyte disorders, nasal infections, oral odor, etc.

Diffusion of laryngeal cancer

Laryngeal cancer can be spread in the following three ways according to its degree of differentiation and the original site:

1 direct spread: advanced laryngeal cancer often infiltrate and spread under the mucosa. Located on the door of the epiglottis, it can invade the epiglottis, ruin and tongue. The sputum will spread out to the piriform fossa and the laryngeal wall. Glottic cancer can advance to the anterior commissure and spread to the contralateral vocal cords; it can also destroy the thyroid cartilage forward, make the larynx enlarge, and have soft tissue infiltration before the neck. Subglottic carcinoma spreads down to the trachea, and can also break through the ring membrane to the anterior cervical muscle layer, develop to the sides, invade the thyroid; and involve the anterior wall of the esophagus.

2 Lymphatic metastasis: The metastatic site is more common in the lymph nodes at the bifurcation of the common carotid artery in the upper cervical group, and then develops along the upper and lower lymph nodes of the internal jugular vein. Subglottic carcinoma often metastasizes to the gas and para-lymph node groups.

3 vascular metastasis: can be transferred to the lungs, liver, kidney, bone, pituitary and so on.

Laryngeal cancer symptoms Common symptoms Difficulty breathing When swallowing neck, swallowing difficulty, swallowing disorder, hoarseness

(1) Glottic type: It is located in the throat and above the throat, including the anterior larynx, the epiglottis, the epiglottis, the chamber and the throat. Due to the rich lymphatic vessels, rapid development, early lymph node metastasis, poor prognosis.

(2) glottic type: the cancer that is confined to the vocal cords. In the previous stage, there were more middle segments, better differentiation, slower development, and less metastasis due to less lymphatic vessels. It can also be developed up and down.

(3) subglottic type: cancer located below the vocal cord plane. Cancer can progress forward and invade the thyroid gland, back to the esophagus. This type of development is faster than vocal cord cancer, and the cancer on this glottis is slower.

Laryngeal cancer examination

Neck examination

Includes diagnosis and palpation of the shape of the larynx and cervical lymph nodes. To observe whether the larynx is enlarged, the palpation of the cervical lymph nodes should be based on the distribution of cervical lymph nodes, from top to bottom, from front to back, to find out the location and size of the enlarged lymph nodes.

Laryngoscopy

1) Indirect laryngoscopy. The easiest way to do this is in the clinic. It is necessary to look at the parts of the throat during the inspection. Due to patient coordination problems, sometimes it is not possible to check the structure of the throat, and further examinations such as fiber laryngoscopy are needed.

2) Direct laryngoscopy. For those who have difficulty in biopsy under indirect laryngoscopy, this method can be used, but the patient is more painful.

3) Fiber laryngoscopy. The fiber laryngoscope mirror is slender, soft, flexible, bright, has a certain magnification function, and has the function of taking biopsy, which is good for seeing the whole appearance of the laryngeal cavity and adjacent structures, which is conducive to early detection of tumors and biopsy.

4) Stroboscopic laryngoscopy. By dynamically observing the vibration of the vocal cords, tumors can be detected early.

Film degree exam

X-ray, CT and MRI can determine the status and metastasis of laryngeal cancer invading surrounding tissue tubes. Through superficial ultrasound imaging, the relationship between metastatic lymph nodes and surrounding tissues can be observed.

Biopsy

Live histopathology is the main basis for the diagnosis of laryngeal cancer. Specimen collection can be done under the laryngoscope. Note that the center of the tumor should be clamped and not taken on the ulcer surface because there is necrotic tissue. Some require repeated biopsies to confirm. The biopsy should not be too deep or too deep to avoid bleeding.

Diagnosis of laryngeal cancer

diagnosis

A detailed medical history and physical examination of the head and neck, indirect laryngoscopy, throat X-ray film, laryngeal CT, MRI, etc. can determine the location, size and extent of laryngeal cancer lesions.

Pathological biopsy under indirect laryngoscopy or fiberoptic laryngoscopy is the most important method for determining laryngeal cancer. If necessary, biopsy can be performed under direct laryngoscopy. The size of the pathological specimen varies depending on the location. The laryngeal cancer in the supraglottic region can take a larger biopsy specimen, and the glottic specimen should not be too large to avoid permanent vocal cord injury.

Differential diagnosis

1. The early stage of laryngeal tuberculosis should be differentiated. The laryngeal tuberculosis is mostly located in the back of the larynx. It is characterized by pale laryngeal mucosa, edema, and multiple superficial ulcers. The main symptoms of laryngeal tuberculosis are hoarseness and sore throat, and chest X-ray and tuberculosis test are helpful for differential diagnosis, but the final diagnosis requires biopsy.

2. Laryngeal papilloma is characterized by hoarseness and difficulty breathing. Its appearance is rough, pale red, difficult to identify with the naked eye, especially adult laryngeal papilloma is a precancerous lesion, which must be identified by biopsy.

3, laryngeal amyloid tumor non-authentic tumor, may be due to chronic inflammation, blood and lymph circulation disorders, metabolic disorders caused by amyloidosis of the laryngeal tissue, manifested as hoarseness, examination revealed dark red mass under the throat, vocal cord or glottis , smooth, biopsy is not easy to clamp. A pathological examination is needed to identify.

4, laryngeal syphilis lesions are mostly located in the front of the throat, often syphilis, followed by deep ulcers, scar tissue formation after healing leads to laryngeal deformity. The patient is vocal but powerful and has a milder sore throat. Generally have a history of sexually transmitted diseases, feasible syphilis related tests, biopsy can confirm.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.