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28 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Tumors in the larynx may be managed primarily by:
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radiotx or surgery, w/chemo as an adjuvant treatment
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282
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What three areas is the the larynx staged in?
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supraglottis
glottis subglottis |
282
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60% of malignant laryngeal tumors occur in the _ area
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glottic
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282
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35% of malignant laryngeal tumors occur in the _ area
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supraglottic
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282
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5% of malignant laryngeal tumors occur in the _ area
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subglottic
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282
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N0 indicates that:
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no nodes are invovled with tumor
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282
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T1N0MO lesion is:
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a small lesion with no nodal or distant metastasis
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282
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Who stages the pt's tumor before treatment?
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primary physician diagnosing the pt, usually an otolaryngologist or general surgeon
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283
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Horizontal or supraglottic laryngectomy is
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a partial laryngectomy procedure which is for smaller lesions on the supraglottic larynx, predominantly the epiglottis, aryepiglottic fold, or the fvf
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284
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A lesion below the fvf requires resection of
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part or all of the hyoid
epiglottis superiorly the aryepiglottic folds the fvf |
285
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standard supraglottic laryngectomy
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removes the structures contributing to airway protection during swallow:
1. the epiglottis and aryepiglottic folds 2. the fvf It leaves the base of tongue, arytenoids, and tvf as it's only protective mechanism |
285
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After a supraglottic laryngectomy,in order to learn how to swallow, the pt must
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completely occlude the airway entrance
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vertical laryngectomy or hemilarngectomy involves
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physical removal of one vertical half of the larynx
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289
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a hemilaryngectomy resection includes
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on fvf
one ventricle one tvf + part of arytenoid cartilage and part of thyroid cartilage |
289
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Are the epiglottis and hyoid resected during a hemilaryngectomy?
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No
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289
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frontolateral laryngectomy
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a hemilaryngectomy + one third of the anterior portion of the larynx on both sides
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290
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three-forths laryngectomy
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when a hemilaryngectomy is extended to the anterior commissure to include one half of the other side of the larynx
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290
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hemilaryngectomees, frontolateral laryngectomees and three-forths laryngectomees benefit from which posture
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chin down and head rotated
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290
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When the arytenoid cartilage is included in the resection, thept's chances of returning to normal swallow with no aspiration are greatly _
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decreased
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291
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Large lesions involving more than one region of the larynx usually require:
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total laryngectomy or
high-dose radiation w/ or w/o chemo |
293
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Do those who have had a total laryngectomy run the risk of aspiration?
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No
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293
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Name the two types of problems encountered by total laryngectomees
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pseudoepiglottis
tightness of the surgical closure (stricture) |
295
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the Staffieri neoglottis procedure
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an attempted technique for reconnecting pulmonary airflow to the pharyngoesophagus that results in the aspiration - it has been discontinued
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295
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the tracheoesophageal puncture procedure
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the most continously successful surgical prostehetic procedure; involves placement of a small felxible prosthesis into a puncture wound made at 12 o'clock on the pt's stoma that connects the trachea w/the esophagus below the level of the vibratory segment; it prevents the backflow of material from the esophagus into the trachea, so aspiration is eliminated
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295
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Panje procedure
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like the tracheoesophageal puncture procedure; together these are the most unifromly sucessful procedures to rapidly restore optimum voice to total laryngectomy pts.
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296
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pharyngospasm is
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a functional phenomenon and is not structural (not present except when air is introduced into the pharynx from below)
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296
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a neurectomy is
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cutting the innervation to the pharyngeal wall muscularture rather than cutting the musculature itself
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296
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Two types of procedures used to eliminated pharyngospasm
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cricopharyngeal myotomy
neurectomy |
296
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