There are methods for laryngeal cancer are not terrible prevention and control

Li Changjiang Wu Haitao

The laryngeal cancer is a common malignant tumor in the head and neck, accounting for about 1%-2%of malignant tumors in the body, but it is the second largest cancer in the respiratory tract, second only to lung cancer, and is more common in male population 40-70. The laryngeal cancer not only brings physiological and psychological pain to the patients, but also bring a lot of economic burden on the patient's family and society. In severe cases, it will affect the exchanges and work of individuals in society, and even threatened life. At present, advanced cancer is almost a worldwide problem and has not been overcome, but patients with early laryngeal cancer have more than 80%-90%of the cure rate. Therefore, early detection of laryngeal cancer to prevent them from progressing as advanced laryngeal cancer is essential for the prevention and control of laryngeal cancer.

Seize the timing of "vocal cord white spots"

So far, the cause of laryngeal cancer is complicated and has not yet been clarified. It may be related to hereditary, smoking and drinking, virus infection, environmental factors, radiation, and trace element deficiency. However, there are some factors closely related to laryngeal cancer. Their existence increases the risk of laryngeal cancer. For example, smoking is the largest carcinogenic factor, both smoking and drinking, and the probability of suffering from laryngeal cancer must be doubled.

"Prelude" of laryngeal cancer -vocal cord white spots

Many laryngeal cancer develops from the lesions of the laryngeal cancer. The proliferative lesions of the laryngeal cancer include leukoplakia, hypertrophy laryngealitis and laryngeal papillanoma.

Although the vocal cord white spots are considered a pre -cancer lesion, its treatment has not yet reached a consensus. Because it is in the middle transitional state of inflammation and cancer, is there too much inflammation or already cancer? It is difficult to determine it alone.

According to clinical experience, doctors can identify according to its appearance. Most vocal cord white spots can be divided into 3 categories from appearance: smooth and flat, smooth and thick and rough. Most of the smooth and flat types have no or only mild and unprecedented hyperplasia. These white spots are preferred conservative treatment; most of the smooth and thick thickness types are moderate and unprecedented hyperplasia. They can choose surgery or follow -up treatment according to the patient's wishes. Not typical hyperplasia, or even cancer, should be actively surgically treated for this part of the lesion.

For the same white spots, different hospitals and different doctors may have different treatment methods, but no matter what type of vocal cord white spots, they should go to the hospital specialist in time. It is of extremely important significance.

Don't miss these early throat cancer signals

There are some signals in the early throat cancer, don't miss it.

[Sound hoarse] Many patients with laryngeal cancer often have symptoms of "sounding" in the early days, but it is easy to consider "laryngitis" and ignore it, especially patients with chronic laryngitis. Therefore, men with a history of smoking over 40 years of age are reminded that if patients with theirsing for more than 2 weeks, patients with no improvement and general treatment without improvement should be further checked.

[Sore throat discomfort] Feeling upper throat discomfort, such as foreign body sensation, itching, cough, and blood in sputum, you should also avoid being considered to be chronic pharyngitis and despise.

Related examinations in the throat are generally not included in conventional medical examination items. If you detect the above -mentioned early laryngeal cancer signal prompts in life, you can go to the hospital for relevant examinations.

[Conventional laryngeal mirror examination] The laryngeal mirror examination is very intuitive. If there are new creatures in the throat, it is easy to be discovered.

[Narrow Bandry laryngeal mirror (NBI)] This is a new technology widely used in recent years. The narrow band laryngeal mirrors use the tan spots on the surface of the vocal cord to determine the pre -cancer lesions and non -cancer lesions, as well as identifying pre -cancer lesions (such as white spots of vocal cords) Whether cancerous.

[CT or MRI in the throat] No significant changes to the surface, the lesions that are mainly infiltrated under the mucosa or deep and surrounding are better identified. It is also conducive to determining the scope of tumor invasion, and has a higher reference value for the next diagnosis and treatment.

How to treat laryngeal cancer

After the examination, if there are tumors or neonatal or cancer lesions in the throat, a biopsy surgery is performed immediately to clarify whether it is cancerous. If it is cancerous, it is necessary to further cure surgery. There are many ways to choose from about the treatment of laryngeal cancer.

[Laser resection] For early laryngeal cancer, laser or plasma minimally invasive surgery is the first choice. Its surgical trauma is small, no trachea is needed, and the body surface has no surgical incision. It can be discharged on the first day after surgery. Later, the voice improved significantly, and the voice was close to normal after a few years. The 5 -year survival rate is more than 90%.

[Radiotherapy] It is also the first choice of early laryngeal cancer, with a 5 -year survival rate of more than 90%. The advantage of radiotherapy is that the voice function is good in the near future, but there are also defects, such as acute and chronic radiotherapy complications, and the oral mucosa, saliva glands and blood system are more damage. In addition, after a few years, radiotherapy complications may gradually occur, mainly because it is difficult to swallow and the pronunciation function.

[Plastic partial resection] If the tumor range is large, laser or plasma minimally invasive surgery is difficult, or the laryngeal cavity is not exposed well, open larynx part is required. The advantage of this surgery is that the lesions are exposed and can better remove the lesion. The disadvantage is that the sound of the sound is the highest and the trauma is the highest.

The above methods can treat early laryngeal cancer well, each with advantages and disadvantages, and you need to choose according to your own situation.

[Total laryngeal dehumidation] It is suitable for patients with mid -to -advanced throat cancer. Due to the greater impact of full -throat resection on the pronunciation function, it is difficult for many patients to undergo full laryngeal cutting, especially patients with light age. However, with the development of surgical technology, there are currently some ways to meet patients' desire for pronunciation function.

How to speak after whole throat resection?

[Esophageal pronunciation] Esophageal pronunciation training is the most commonly used pronunciation recovery method after full throat resection.Patients after surgery can carry out esophageal pronunciation training.The advantage of esophageal pronunciation is that the pronunciation is natural, the cost is low, but it is not continuous and the volume is low. The success rate of continuous speech is less than 50%.Patients over 70 years of age are difficult to master the pronunciation method, and the success rate is lower.

[Electronic throat] It is an external mechanical device. The sound changes are single and mechanical. It is difficult to understand.

[Pronunciation button] Natural and smooth sounds. The disadvantage is that the cost is high. It needs to be replaced regularly. It may also cause complications such as expansion of fistula and granulation hyperplasia.

[Surgery Pronunciation and Reconstruction] After many years of research, patients can be applied to autologous tissues, such as the front of the neck -like muscle skin and the clycladeshopper muscle skin flap, which is made into a pronunciation tube to rebuild the pronunciation function for patients with full laryngeal resection.The reconstruction of pronunciation is more difficult, and it can be performed during the same period as the laryngeal cancer surgery.

(The author works at the Department of ENT Department of the Department of Earlilic and Ear and Throat of Fudan University. Li Changjiang is the attending physician and Wu Haitao is the chief physician)

- END -