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28 Cards in this Set

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