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AFTER ORAL AND LARYNGEAL CANCER - Coggle Diagram
AFTER ORAL AND
LARYNGEAL CANCER
ETIOLOGIES
HEAD AND NECK CANCER
= common term for multiple cancers that
can develop in the head and/or neck regions
Laryngeal cancer = malignant cells form in
the tissues of the larynx
Oral cancer = malignant cells form in the tissues
of the lips, mouth, gums, and tongue
90% of cases: squamous-cell carcinoma,
abnormal growth of the thin and flat cells found in
the tissues that form the skin surface, hollow organs lining, respiratory and digestive tract lining
Relatively rare in comparison to other cancers
SURGERIES
Laryngeal cancer
Partial laryngectomy
Total laryngectomy
Endoscopic resection
(laser removal)
Oral cancer
Glossectomy
Mandibulogectomy
(marginal or segmental)
Maxillectomy
Treatments
Radiotherapy (controlled doses of high-energy radiation)
Chemotherapy (medicine that kills cancer cells
Surgery!
SPEECH CHANGES
Laryngeal Cancer
Clinical manifestations
Supraglottic: dysphagia, hoarseness later
Subglottic: airway obstruction, hoarseness later
Glottic: hoarseness as a common early sign
Voice changes after surgery
Partial laryngectomy: some vocal cords are left in place, partial speech function, hoarse or weak voice afterwards
Total laryngectomy: voice cords are removed, extensive speech therapy necessary, normal way of speech not possible
Endoscopic resection: soar mouth and throat,
risk of (permanent) voice changes
Outcomes
Electrolarynx speech
Mechanical quality of voice (although pitch variation)
High success rate
Esophagal speech
Low success rate + extensive training necessary
Doesn't need any equipment (air moved down into esophagus, pharyngeal walls tense to create sound)
Voice Prothesis /
Tracheo-oesophagal speech
Highest success rate + most common
Stoma is occluded, allows speech!
SPEECH CHANGES
Oral Cancer
Clinical manifestations
Oral: affecting the front part of the tongue
Oropharyngeal: affecting the back part of the tongue
red/white patches on tongue, lumps on the side of the tongue, red/grey ulcers, changes in voice (esp. after affecting larynx)
Treatments
Total glossectomy
Subtotal glossectomy
Hemiglossectomy
Partial glossectomy
Reconstruction necessary!
Outcomes
Reduced tongue mobility and swallowing function
Reduced articulation and intelligibility issues
Size of tumour is related to intelligibillity
the smaller the tumor, the better the outcomes!
General improvements 12 M post-treatment
manner is more predictive than place of articulation
Fricatives more difficult, plosives and vowels the same
Vowel spaces and /K/ production impacted
Reduced Tongue Range of Motion,
crucial for swallowing and speech
protrusion, lateralisation, tip elevation
Reduced jaw Range of Motion + tongue strength
Auditory-kinematic changes, e.g. reduced palatal contact
QUALITY OF LIFE
European Organisation for Research and Treatment if Cancer (EORTC) questionnaire
Affects social life, oral function,
overall wellbeing