Laser Treatment Of Larynx Cancers (Throat Cancer)
What is laryngeal (throat) cancer
Larynx Cancers, It is one of the most common types of cancer that can occur on the vocal cords or adjacent areas to the vocal cords. Although they are more common in men, smokers and older (40-60), the incidence in women has been rising in recent years due to increase smoking. Alcohol is also a risk factor that increases throat cancer, and the risk is much greater when it comes to the use of both alcohol and cigarettes together.
What are the symptoms of Larynx Cancers?
In laryngeal cancers, the patient most often refers to the ENT physician due to hoarseness. Especially when the tumor is located on the vocal cords, hoarseness occurs as the first complaint. If a patient has hoarseness that exceeds two weeks, he/she should be examined by an ENT physician as soon as possible.
In tumors that are not located directly on the vocal cords but located near the vocal cords, sound quality impairment (hoarseness), globus pharyngeus, pain in the throat, pain reflected to the ear, difficulty swallowing in advanced tumors, dyspnea, bloody sputum, swelling in the neck in case of spread to the lymph nodes can be seen.
How is laryigeal cancer diagnosed? – Larynx Cancers
A full Otolaryngology examination is required of the patients who come to the ENT physician with the above mentioned complaints. The best method of examination is to review the larynx area with endoscopy (laryngoscopy). If a mass is detected in the larynx during this examination, the next stage is to take a biopsy from the mass (it usually happens with a short procedure performed with general anesthesia.) and to make a histopathological examination. As a result of this histopathologic examination, the presence of larynx cancer is diagnosed.
In addition, some tests such as ultrasonography, tomography, MRI or Positron emission tomography (PET) can be added to diagnostic methods to assess size of tumor, spread, whether neck lymph nodes are invaded with the tumor and presence of spread to distant organs of body.
How to treat cancer of the larynx? – Larynx Cancers
In general, treatment procedures such as surgery (removal of tumor tissue with intact tissue boundaries), radiotherapy and chemotherapy are used in the treatment of larynx cancers. The success rate of surgery and radiation treatments are quite high, especially in early stage tumors. Chemotherapy is used more common in advanced stage cancers. Surgery usually involves partial or complete removal of the larynx, depending on the stage of the tumor.
In early stage tumors, it is possible to remove of the larynx partially with an incision made from the neck, called open surgery, but can also be done with a closed method through the mouth using laser. These procedures should be performed under general anesthesia. Before or during the procedure, it may sometimes be necessary to open a temporary hole (tracheotomy) from the neck. In advanced stage tumors that require full removal of the larynx will need to have a permanent hole in the neck.
The removal of lymph nodes procedure in the neck (neck dissection) may also be added to the surgery during partial or complete removal of the larynx depending on the presence of the lymph nodes in the neck.
How is LASER surgery performed in larynx cancers and what are the advantages? – Larynx Cancers
As we mentioned earlier, laser surgery of larynx tumors is done in the early stages (stages 1 and 2). However, it can also be applied in a limited number of advanced stage tumors. The procedure is performed under general anesthesia and the tumor in the larynx is accessed by mouth without an external incision. During the operation, a microscope is always used and this provides a closer view to the tumor.
The most common LASER types used in larynx cancers are the “Carbon dioxide and “Diode” LASER. Larynx tumor surgery performed by LASER (these surgeries are also called “ENDOLARYNGEAL LASER SURGERY”) has some advantages over surgical procedures (open technical surgeries) performed by an external incision from the neck:
- Because it is done with a microscope, it is possible to see the tumor boundaries better and remove the tumor in a more confident way.
- Bleeding during surgery is less.
- Better sound quality is achieved by protecting normal tissue (Protecting normal tissues is especially important for vocal cords). Hoarseness is the most important problem of patients, especially after open surgeries and it is less in laser surgeries.
- It is rarely necessary to make a hole in the throat (tracheotomy) before or during surgery.
- Patients are discharged from the hospital earlier and wound healing takes place in a shorter time.
As with all tumor surgeries, the main purpose of partial laryngeal surgeries is also to ensure the complete removal of the tumor with intact borders. However, swallowing without aspiration, a life without tracheotomy and a better voice quality are our other important goals after surgery. All these goals are easier to achieve especially with LASER surgery.
In the meantime, if a patient has lymph node involvement in the neck, neck cleaning (neck dissection) is generally performed approximately 1-1.5 months later from laser surgery. These procedures, called neck dissection, are performed with open surgeries using external incisions.
Prof. Dr. Özcan Öztürk – Ear Nose Throat Diseases
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