ENT oncology - Throat and larynx cancer
ENT oncology - Throat and larynx cancer
Hypopharynx oncology means laryngeal cancer.
Hypopharynx cancer is rare. The hypopharynx is located between the oropharynx and the larynx.
Clinical signs are pain when swallowing (odynophagia) or a feeling of blockage during the passage of food (dysphagia).
Risk factors are smoking and / or drinking. Most tumors are localized in the piriform sinus and give a metastatic lesion of the lymph nodes.
Squamous cell carcinoma mainly appears in this place.

Anatomical boundaries of the location of the tumor: from the upper plane of the hyoid bone to the lower edge of the thyroid cartilage.

It is necessary to conduct additional examinations, such as CT of the cervicothoracic region with injection of iodine contrast. Panendoscopy of the upper digestive tract and pulmonary fibroscopy are performed under general anesthesia.

To confirm the diagnosis and determine the treatment protocol, a biopsy of the primary tumor and / or aspiration of one of the suspected lymph nodes is performed.
A dental examination is also performed, but with extreme caution. To maintain the general condition of the patient, nutritional support is proposed, as patients often experience a change in their general condition with severe weight loss.

The principle of therapeutic treatment of laryngeal cancer has many similarities to the treatment of throat cancer: the main goal is to preserve the larynx. In the case of small tumors, exclusive radiotherapy is offered: 70 Gy for 33–35 sessions of 2 Gy for seven weeks for a tumor and affected lymph nodes, as well as a preventive dose of 45 to 50 Gy for optional lymph nodes (i.e., potentially suffered from a tumor).

Surgery with preservation of the larynx and bilateral dissection of the lymph node is one of the possible treatment regimens. It should be supplemented with postoperative radiotherapy, and possibly, in some cases, chemotherapy (in the case of damage to the lymph nodes, positive surgical margins (incomplete resection), perinervic membrane and / or vascular embolism or cartilage invasion).

Unfortunately, the vast majority of patients are in the late stages with the involvement of the cervical or metastatic lymph node during diagnosis. It is worth noting that radiotherapy-chemotherapy is often preferable to surgical intervention, especially when it comes to complete laryngectomy with tracheostomy.

However, in the case of a non-functional larynx, surgical treatment will be preferable to protect the airways from ingestion of food.
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