Cancer of larynx

1. Cancer of Larynx

2. Definition
• The cancer of laryngeal cells.

3. Classification
• Glottic tumour: tumour in the glottis.
• Sub-glottic tumour: tumour in the sub-glottic
area.
• Supra-glottic tumour: Tumour in the supraglottic area.

4. Etiology
• Cigarette smoking
• Alcoholism
• Occupational risk factors : asbestos, wound
dust, mustard gas & petroleum products.
• Inhalation of noxious fumes
• Chronic laryngitis and voice abuse

5. Pathophysiology
Etiological factors
Carcinoma of the squamous cell lining of the
larynx
Rapid metastasis of the carcinoma, due to
abundant lymphatic vessels, into lymph nodes
and lungs

6. Clinical Manifestations
Glottic tumour
• Voice changes
• Hoarsness
• Hemoptysis
• Dyspnoea
• Respiratory obstruction
• Dysphagia
• Weight loss
• Pain
Supraglottic tumor
• Aspiration on swallowing
• Persistent unilateral sore
throat
• Foreign body
• Dysphagia
• Weight loss
• Mass in neck
• Hemoptysis

7. Supraglottic tumour
• Dyspnoea
• Airway obstruction
• Dysphagia
• Weight loss
• Hemoptysis

8. Diagnostic finding
• Physical examination: swollen lymph nodes in
the neck
• Indirect laryngoscopy
• Direct laryngoscopy
• Pan endoscopy
• CT and MRI scan
• Biopsy

9. Medical management
• Radiation therapy is given 5 days a week for 58 weeks.

10. Surgical Management
• Laser surgery : for vocal cord tumours.
• Partial laryngectomy / Vertical partial
laryngectomy: Removal of half or more of
the larynx
– Supraglottic laryngectomy: for Ca of supraglottis
– Supra-cricoid partial laryngectomy: for confined
transglottic Ca.

11. • Total laryngectomy: For glottic tumours
• Cervical lymph node dissection / Neck
dissection:
– Radical neck dissection / En Bloc
– Modified radical neck dissection

12. Complications of surgery
•
•
•
•
Haemorrhage
Airway obstruction
Carotid artery rupture
Fistula formation

13. Nursing Management
Partial laryngectomy
– Assess ABG values, pulse oximetry & FiO2 levels
– Semi fowlers to High fowlers position
– Monitor oxygen therapy
– Tracheostomy care and suctioning
– Chest physiotherapy
– Nebulization

14. Total laryngectomy
• Nutrition
– Tube feeding
– Start oral feeding with fluids & semi-soft foods
• Communication
– Give pen and paper
– Communication board
– Keep speaking with the client; do not avoid
conversation because it will build up frustration
• Artificial larynx
– Can be used after 3-4 days of surgery

15. The end