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Mr. Manikandan.T,
RN., RM., M.Sc(N)., D.C.A .,(Ph.D)
Assistant Professor,
Dept. of Medical Surgical Nursing,
VMCON, Puduch...
DEFINITION
• Cancer of the larynx
• Abnormal growth and proliferation of
cells(larynx)
Incidence
• about 11,300 new cases and 3,660 deaths
occur annually, with an overall survival rate of
65%. Cancer of the la...
CAUSES/RISK FACTORS
• Tobacco
• Alcohol
• Occupational exposure to coal dust, steel dust, iron compounds and fumes,
formal...
CLINICAL FEATURES
• Hoarseness
• Lump in throat or pain or burning when
drinking citrus juices or hot liquids
• Dysphagia
...
DIAGNOSIS
• H.C
• P/E
• Laryngoscopy
• CT
• Chest X-Ray
STAGING - TNM
T
• T is – CA in-situ
• T1- Limited to subglotis
• T2- extends to vocal cord
• T3 – limited to larynx
• T4a-...
MANAGEMENT
• Radiation therapy,
• chemotherapy.
• Surgical procedures may include transoral
endoscopic laser resection
• c...
SURGICAL MANAGEMENT
• Vocal Cord Stripping:
Stripping of the cord is used. The procedure
involves removal of the mucosa of...
• Laser Surgery
Laser microsurgery is well known to have
several advantages for treatment of early
glottic cancers.
• Micr...
Partial laryngectomy
• A partial laryngectomy (laryngofissure–thyrotomy) is
often used for smaller cancers of the larynx.
...
• Total Laryngectomy : Complete removal of the
larynx (total laryngectomy) can provide the
desired cure in most advanced l...
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Larynx cancer

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BSC NURSING III YEAR

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Larynx cancer

  1. 1. Mr. Manikandan.T, RN., RM., M.Sc(N)., D.C.A .,(Ph.D) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry.
  2. 2. DEFINITION • Cancer of the larynx • Abnormal growth and proliferation of cells(larynx)
  3. 3. Incidence • about 11,300 new cases and 3,660 deaths occur annually, with an overall survival rate of 65%. Cancer of the larynx is most common in people between the ages of 60 and 70 years , and it occurs four to five times more frequently in men than in women.
  4. 4. CAUSES/RISK FACTORS • Tobacco • Alcohol • Occupational exposure to coal dust, steel dust, iron compounds and fumes, formaldehyde, and dust from hard alloys (eg., still or iron compounds) • Dietary patterns of Western cultures are associated with an increased risk of supraglottic cancer of the larynx. • straining the voice • family predisposition. • Tobacco (smoke, smokeless) • Asbestos, Paint fumes, Wood dust, Cement dust, Chemicals Other Factors • Straining the voice • Chronic laryngitis • Nutritional deficiencies (riboflavin) • History of alcohol abuse • Age (higher incidence after 60 years of age) • Gender (more common in men) • Weakened immune system
  5. 5. CLINICAL FEATURES • Hoarseness • Lump in throat or pain or burning when drinking citrus juices or hot liquids • Dysphagia • Dyspnea • Enlargement of lympnodes • Weight loss
  6. 6. DIAGNOSIS • H.C • P/E • Laryngoscopy • CT • Chest X-Ray
  7. 7. STAGING - TNM T • T is – CA in-situ • T1- Limited to subglotis • T2- extends to vocal cord • T3 – limited to larynx • T4a- invades thyroid cartilage, tissue beyond larynx • T4b-invades prevertebral space, carotid artery, mediatibal structure N • N0- No regional lymphnode • N1 – single node 3cm or less • N2a – single node 3-6 cm • N2b- multiple node – 6 cm • N2c – bilateral 6 cm • N3- node more than 6 cm M • MX- Unknown • M0- no distant metastasis • MM1- distant metastasis
  8. 8. MANAGEMENT • Radiation therapy, • chemotherapy. • Surgical procedures may include transoral endoscopic laser resection • classic open vertical hemilaryngectomy for glottic tumors, or classic horizontal supraglottic laryngectomy. • In supraglottic tumors, selective neck dissection or irradiation is necessary because of the high risk of neck node involvement
  9. 9. SURGICAL MANAGEMENT • Vocal Cord Stripping: Stripping of the cord is used. The procedure involves removal of the mucosa of the edge of the vocal cord, using an operating microscope. Early vocal cord lesions are initially treated with radiation therapy. • Cordectomy: Cordectomy, which is an excision of the vocal cord, is usually performed via transoral laser. This procedure is used for lesions limited to the middle third of the vocal cord. The resulting voice quality is related to the extent of tissue removed.
  10. 10. • Laser Surgery Laser microsurgery is well known to have several advantages for treatment of early glottic cancers. • Microelectrodes are useful for surgical resection of smaller laryngeal carcinomas. The carbon dioxide (CO2) laser can be used for the treatment of many laryngeal tumors, with the exception of large vascular tumors.
  11. 11. Partial laryngectomy • A partial laryngectomy (laryngofissure–thyrotomy) is often used for smaller cancers of the larynx. • It is recommended in 540 Unit 5 Gas Exchange and Respiratory Function the early stages of cancer in the glottic area when only one vocal cord is involved. • A portion of the larynx is removed, along with one vocal cord and the tumor; all other structures remain. The airway remains intact, and the patient is expected to have no difficulty swallowing. • The voice quality may change, or the patient may sound hoarse.
  12. 12. • Total Laryngectomy : Complete removal of the larynx (total laryngectomy) can provide the desired cure in most advanced laryngeal cancers, when the tumor extends beyond the vocal cords. the laryngeal structures are removed, including the hyoid bone, epiglottis, cricoid cartilage, and two or three rings of the trachea. The tongue, pharyngeal walls, and trachea are preserved. • A total laryngectomy results in permanent loss of the voice and a change in the airway, requiring a permanent tracheostomy
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BSC NURSING III YEAR

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