Laryngeal cancer treatment

nullvolume of damage to the larynx. Hoarseness of the voice is an early sign when the carcinoma is located on the vocal folds, but appears in the later stages when localized in the supraclad and subclad sections. Patients with sublingual cancer often have airway obstruction and hoarseness is a common symptom in the later stages. Patients with over-ligamentous cancer often have dysphagia; other characteristic symptoms of this disease are airway obstruction, otalgia, the development of a tumor in the neck, a muffled voice. Patients with these symptoms should be immediately referred for indirect laryngoscopy.DiagnosticsLaryngoscopySurgical endoscopy andnullnullEndoscopic laser resection and radiation therapy, as a rule, allow you to save the voice of patients. The use for the treatment of laryngeal cancer in the early stages of surgery or radiation therapy, as a rule, depends on the preferences of the doctors of the institution and the patient.In the later stages of vocal fold carcinoma, they are immobilized or involved in the process of the tongue; patients are shown chemotherapy or radiation therapy. If the patient's tumor has spread beyond the larynx or has penetrated into the cartilage, laryngectomy provides the best oncological results; laryngectomy is most often extensive, but in some casesendoscopic laser resection of the tumor or open partial laryngectomy can be used. Extensive laryngectomy is also widely used in difficult situations to save the patient; however, sometimes in such situations, endoscopic resection or open partial laryngectomy may be used.In the early stages of carcinoma of the supraclavicular larynx, radiation therapy or partial resection of the larynx are effective. The use of laser resection in the early stages of squamous cell carcinoma has shown quite good results. If the carcinoma continues to develop, but does not affect the real vocal cords, then a partial nasal laryngectomy can be performed to preserve the voice andsphincter of glottis. If the patient also has vocal cords, laryngectomy over the cricoid cartilage or total laryngectomy is required, if it is decided to carry out surgical treatment. As in the case of laryngocarcinoma, most of the progressive stages of supermucosal cancer are initially treated with chemotherapy and radiation therapy. The ligamentous region has a rich lymphatic network, therefore, special attention should be given to the neck region in all patients with ligamentous cancer.With carcinoma of the lower pharynx, the treatment is the same as with cancer of the larynx. In the early stages, damage is usually treated with onlyradiation therapy, or endoscopic resection as an alternative. However, in most patients with submaryngeal cancer, progress is associated with the asymptomatic nature of the disease and frequent local spread through the lymphatic system; such patients are treated mainly with chemotherapy and radiation therapy, and promptly - according to vital indicators.RehabilitationRehabilitation may be required after any type of treatment. Usually, serious difficulties arise with the process of swallowing food after chemotherapy or radiation therapy, which may require dilatation of the esophagus, in more severe cases, plastic of the pharynx or application of a gastrostomy. During surgicalthe intervention may also interfere with the swallowing process, and treatment may be required, including expansion of the swallowing pathways.Surgery, on the other hand, affects speech more significantly. After total laryngectomy, the patient needs to create a new voice by:    Esophageal voice    Esophageal tracheal puncture    E-throat (electropharynx)With all three methods, speech is formed with the participation of the pharynx, soft palate, tongue, teeth and lips.The basis for the formation of the “esophageal voice” (pseudo-voice) is the creation of a pseudo-voice gap in the esophagus and its developmentarbitrary closure.With tracheoesophageal fistula, a valve is placed between the trachea and esophagus in order to enhance phonation. The valve helps pump air into the esophagus during the inspiration act. Patients undergo physical rehabilitation, courses on speech techniques, they are taught the rules for handling fistula, and all patients are warned about the risk of aspiration of food and water.The electric larynx is a battery-powered device located on the surface of the neck. Despite the discomfort created by social stigma when worn for many patients, it is easy to handle and does not require special training.