Laryngology

LARYNGEAL/ HYPO PHARYNGEAL OR THROAT CANCERS

Cancer of the larynx or throat cancer is the second most common cancer of Head and Neck cancers. It is the 14th most common cancer in men but is much rarer among women. Men are affected 4-5 times more often than women.

Risk factors:

  • Heavy smoking, heavy alcohol consumption ( both have synergistic effect)
  • poor dentition are also the principle risk factors for head and neck cancers
  • Human papillomavirus (HPV) is also associated with an increased risk of oral, pharyngeal and laryngeal cancer
  • Certain occupational hazards like exposure to Formal dehyde, Asbestos, Nickel. Diesel fumes etc also have been implicated

Presentation or symptoms:

  • Chronic hoarseness or change of voice
  • Chronic sore throat and throat pain
  • Dysphagia or pain in swallowing food
  • Lump or swelling in neck
  • Chronic persistent cough, Ear ache
  • Breathlessness, Weakness, Weight loss, coughing out blood

Examination:

  • Examination by ENT Specialist or Head and Neck Onco surgeon
  • Examination of neck to see if there is any palpable lymph node
  • Examination of Oral cavity and Indirect and direct laryngoscopy

Investigations:

  • Fine needle aspiration cytology from swelling in neck if any
  • Direct laryngoscopy and biopsy under general anaesthesia to confirm diagnosis
  • CT Scan/ MRI Scan and Pet Scan
  • X-Ray chest, Ultra sound of neck and abdomen

Treatment modalities:

  • Early stage cancers can be treated with Radiotherapy or surgery depending upon the location of tumor
  • Advanced tumors can be treated with either Chemotherapy combined with Radiotherapy depending on the site of tumour or Total laryngectomy followed by chemo-Radiotherapy

Further information: Can be obtained by internet search on cancer website

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LARYNGOCELE

  • Laryngocele is an unusual sac which develops from in between area of true and false vocal cords and appears as swelling in neck usually on one side near Thyroid cartilage or Adams’s apple in the neck. It is usually filled with air and can be reduced in size by pressure. Sometimes it can get filled with fluid and get infected and presents as an abscess.
  • Laryngoceles are thought to be caused by increased pressure in that portion of the airway between the true and false vocal cords.
  • Laryngoceles can be detected clinically when they produce a lump in the neck. The lump may vary in size. Straining and coughing may cause the lump to increase in size. There may be hoarseness, cough and stridor. Difficulty swallowing may occur.
  • Investigations: USG Neck, CECT of Neck, Fiber optic laryngoscopy
  • Treatment options: Surgical excision of the Laryngocele is the only option.
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