Cancer of larynx

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Cancer of larynx

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Cancer of larynx

  1. 1. Cancer of Larynx
  2. 2. Definition • The cancer of laryngeal cells.
  3. 3. Classification • Glottic tumour: tumour in the glottis. • Sub-glottic tumour: tumour in the sub-glottic area. • Supra-glottic tumour: Tumour in the supraglottic area.
  4. 4. Etiology • Cigarette smoking • Alcoholism • Occupational risk factors : asbestos, wound dust, mustard gas & petroleum products. • Inhalation of noxious fumes • Chronic laryngitis and voice abuse
  5. 5. Pathophysiology Etiological factors Carcinoma of the squamous cell lining of the larynx Rapid metastasis of the carcinoma, due to abundant lymphatic vessels, into lymph nodes and lungs
  6. 6. Clinical Manifestations Glottic tumour • Voice changes • Hoarsness • Hemoptysis • Dyspnoea • Respiratory obstruction • Dysphagia • Weight loss • Pain Supraglottic tumor • Aspiration on swallowing • Persistent unilateral sore throat • Foreign body • Dysphagia • Weight loss • Mass in neck • Hemoptysis
  7. 7. Supraglottic tumour • Dyspnoea • Airway obstruction • Dysphagia • Weight loss • Hemoptysis
  8. 8. Diagnostic finding • Physical examination: swollen lymph nodes in the neck • Indirect laryngoscopy • Direct laryngoscopy • Pan endoscopy • CT and MRI scan • Biopsy
  9. 9. Medical management • Radiation therapy is given 5 days a week for 58 weeks.
  10. 10. Surgical Management • Laser surgery : for vocal cord tumours. • Partial laryngectomy / Vertical partial laryngectomy: Removal of half or more of the larynx – Supraglottic laryngectomy: for Ca of supraglottis – Supra-cricoid partial laryngectomy: for confined transglottic Ca.
  11. 11. • Total laryngectomy: For glottic tumours • Cervical lymph node dissection / Neck dissection: – Radical neck dissection / En Bloc – Modified radical neck dissection
  12. 12. Complications of surgery • • • • Haemorrhage Airway obstruction Carotid artery rupture Fistula formation
  13. 13. Nursing Management Partial laryngectomy – Assess ABG values, pulse oximetry & FiO2 levels – Semi fowlers to High fowlers position – Monitor oxygen therapy – Tracheostomy care and suctioning – Chest physiotherapy – Nebulization
  14. 14. Total laryngectomy • Nutrition – Tube feeding – Start oral feeding with fluids & semi-soft foods • Communication – Give pen and paper – Communication board – Keep speaking with the client; do not avoid conversation because it will build up frustration • Artificial larynx – Can be used after 3-4 days of surgery
  15. 15. The end

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