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6.4 Laryngeal carcinoma 喉癌 - Coggle Diagram
6.4 Laryngeal carcinoma 喉癌
laryngeal tumor
malignant tumours
benign tumours (papilloma, nodules, polyps)
types
glottic
sound hoarseness 声音嘶哑 (early, progressive), breathing difficulty
subglottic
rare
, breathing difficulty
supraglottic
foreign body sensation (early), lymphadenopathy 淋巴结病
risk factors
abusing the voice, cigarette smoking, chronic gastric reflux, prior history of head and neck irradiation
clinical manifestations
mass effects: hoarseness, dysphagia, airway compromise (difficulty in breathing)
throat & ear pain
sound hoarseness (rough voice)
weight loss (since cancer cells used up the body's energy supply)
nursing diagnosis & interventions
IMPAIRED VERBAL COMMUNICATION
esophageal speech, use prosthesis to assist with speech
IMBALANCED NUTRITION: less than body requirements related to impaired swallowing
NGT feeding & nutrition supplements
RISK FOR IMPAIRED AIRWAY CLEARANCE
maintain pt airway and oxygen supply, tracheostomy care + suctioning
RISK FOR WOUND INFECTION
care of wound dressing/ drainage
post-laryngectomy complications
wound infection & breakdown, vessel exposure & possible rupture, tracheobronchitis
risk higher if pt has radiation therapy before surgery
diagnostic tests
pathological biopsy
: to examine the cells
larynx and pharynx examination
: laryngoscopy
quality of voice
: breathy voice (=cord paralysis), muffled voice (=supraglottic lesion)
imaging
: plain chest x-ray, CT/MRI, PET scan, barium swallow
physical examination
: larynx shape, cervical lymph nodes (in the neck)
medical & surgical management
lesion
early: surgery & radiation
advanced: combined surgery with chemo-radiation (combined therapy)
surgery
partial laryngectomy
: removal of the tumour only
total laryngectomy
: remove entire larynx
laser surgery under laryngoscope: cut off the cancer cells
neck dissection
: remove of larynx + neck lymph nodes