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Treatment And Complication For Laryngeal Cancer
Posted by Lifenurses on February 1, 2011
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Treatment Management For Laryngeal Cancer Depends on sites and stages
of cancer. Early malignancy may be removed endoscopically. Early lesions
may respond to laser surgery or radiation therapy; advanced lesions to laser
surgery, radiation therapy, and chemotherapy. Treatment aims to eliminate
cancer and preserve speech. If speech preservation isn’t possible, speech
rehabilitation may include esophageal speech or prosthetic devices. Other
surgical procedures vary with tumor size and include cordectomy, partial or
total laryngectomy, Supraglottic laryngectomy, and total laryngectomy with
laryngoplasty.
Treatment Management For Laryngeal Cancer
Radiation therapy:
Singly or in combination with surgery.
2. Complications of radiation including airway obstruction, edema of larynx,
soft tissue and cartilage necrosis, chondritis, pain, and loss of taste
(xerostomia).
Surgery therapy:
Carbon dioxide laser for early-stage disease.
Partial laryngectomy removal of small lesion on true cord, along with a
substantial margin of healthy tissue.
Supraglottic laryngectomy removal of hyoid bone, epiglottis, and false
vocal cords, tracheostomy may be done to maintain adequate airway,
radical neck dissection may be done.
Hemilaryngectomy removal of one true vocal cord, false cord, one half
of thyroid cartilage, arytenoid cartilage.
Total laryngectomy removal of entire larynx (epiglottis, false or true
cords, cricoid cartilage, hyoid bone; two or three tracheal rings are
usually removed when there is extrinsic cancer of the larynx [extension
beyond the vocal cords]). A radical neck dissection may also be done
because of metastasis to cervical lymph nodes.
Total laryngectomy with laryngoplasty voice rehabilitation may be
attempted through the Asai operation: A dermal tube is made from the
upper end of the trachea into the hypo pharynx. The tracheostomy
opening is closed off with a finger. The patient expires air up the dermal
3. tube into the pharyngeal cavity. The sound produced is transformed into
almost normal speech.
Complications of Surgery therapy
Salivary fistula may develop after any surgical procedure that involves
entering the pharynx or esophagus. (Monitor for saliva collecting
beneath the skin flaps or leaking through suture line or drain site.
Management NG tube feeding, meticulous local wound care with
frequent dressing changes, promotion of drainage)
Hemorrhage (carotid artery rupture) or hematoma formation. A major
postoperative complication (e.g. skin necrosis or salivary fistula) usually
precedes carotid artery rupture. Management immediate wound
exploration in operating room.
Stomas stenosis.
Aspiration.
Long-term complications: Chest infections (from repeated aspiration),
Recurrence of cancer in stoma
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Patient with Laryngeal Cancer
4. 3. Risk Factors And Clinical Manifestations For Laryngeal Cancer
4. Nursing Diagnosis for Laryngeal Cancer
5. Nursing Care Plan for Laryngeal Cancer
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