D8

Front 1

for smaller tumors on the TVF,

Back 1

radiotherapy is the more frequent treatment choice

Front 2

cure rates for these small tumors are usually

Back 2

equal with radiotherapy or surgery

Front 3

the larynx is divided into ____ areas for staging

Back 3

3 supraglottis, glottis, subglottis

Front 4

__ percent of tumors occur in the glottic area

Back 4

60%

Front 5

___ percent occur in the supraglottic araea

Back 5

35%

Front 6

___ percent in the subglottic area

Back 6

5%

Front 7

because of the way in which the lymph system drains in the supraglottic larynx, a tumor of the supraglottic larynx will ______

Back 7

not spread downward to the true vocal cord and/or subglottic larynx unless the tumor is located at the base of the epiglottis

Front 8

supraglottic laryngectomy

Back 8

part or all of the hyoid bone and epiglottis, the aryepiglottic folds, and the false vocal foldes

Front 9

it leaves the ________, __________, and ______ as athe only protective mechanism

Back 9

base of tongue, arytenoids, TVF

Front 10

in reconstruction the surgeon usually

Back 10

elevates the remaining larynx and tucks it under the tongue base for additional protection during swallow

Front 11

laryngeal suspention is also affected becuase

Back 11

the hyoid bone is partially or completely removed

Front 12

the tongue base has to make complete contact

Back 12

with the posterior pharyngeal wall because otherwise residue will fall directly into the airway because the patient with a supraglottic laryngectomy has no valleculae and smaller pyriform sinuses than normal

Front 13

the supraglottic laryngectomy can also be extended

Back 13

inferiorly to include part of one vocal fold, or oan arytenoid cartelage. the patients change of normal recovery are slim b/c no protection of airway

Front 14

long term study of supraglottic laryngectomy (normal after how long?)

Back 14

patients with a dtandard resectionwere able to swallow a normal diet at an average of 1 month after surgery

Front 15

those patients with an extended supraglottic to include arytenoid spent a min of ____ months and more frequ ______ months attempting rehab

Back 15

2, 6-12. some could never drink liquids

Front 16

supraglottic with extension to the tongue base - often took

Back 16

6 months or more. some never gianed enough tb movement to protect the airway

Front 17

tongue base and arytenoid range of motion exercisdes have an effect within the first

Back 17

2-4 weeks. exercises can be contingued

Front 18

some pateints attain successful airway protection __ months

Back 18

3-4 months after surgery if they contine to exercise

Front 19

if possible, the onset of postoperative radiotherapy should be

Back 19

delayed until oral intake is reinstated

Front 20

tumors located on the free margin of one VF with only local extension are usually treated with

Back 20

vertical laryngectomy or hemilaryngeactomy. or an extended hemi

Front 21

hemilaryngectomy includes

Back 21

one false VF, one ventricle, and a true vocal fold, usually excluding the arytenoid cartelage as well as the thyroid cart.

Front 22

in hemi, pateitn experiences few dificulties swallowing because some tissue bulk

Back 22

is reconstructed on the operated side, against which the unoperated side can attain normal laryngeal closure during swallowing

Front 23

reconstructed side must be at the same _________

Back 23

level

Front 24

usually, tipping the patients head

Back 24

forward to push the epiglottis more posteriorly and narrow airway entrance helps

Front 25

patients need chin down for only

Back 25

a few weeks postoperatively if they were aspirating

Front 26

sometimes the hemi has to involve the anterior commisure and patients

Back 26

wwill rpobably be rehabd within 2-3 weeks but more may need chin down at first

Front 27

when the arytenoid cart is included in teh resection,

Back 27

the patient's chances of returning to normal swallowing with no aspiration are greatly decreased.

Front 28

if aspiration is controlled by reconstructing a narrow glottic chink,

Back 28

the airway is usually compromised and the functional tradeoff for elimination of aspiration is a perminant trach

Front 29

large lesions (T3 or T4) involving more than one region of the larynx usually require

Back 29

total laryngectomy or high dose radiation with or without chemo

Front 30

with a pseudoepiglottis, the greater the struggle reaction of the patient

Back 30

the greater the widening of the picket and the more severe the difficulty in swallowing

Front 31

dilatation of the esophagus scar tissue stricture has to be repeated

Back 31

often monthly

Front 32

both a pseudoepiglottis and a ________ can result in

Back 32

stricture. backflow of food as the patient struggles to swallow

Front 33

if a total laryngectomy patient has not returned to a full preoperative diet at ________ months postop, ____

Back 33

2 months, a full radiographic study of oropharyngeal and cervical esophageal aspects of swallow should be completed.

Front 34

TE puncture

Back 34

successful

Front 35

if the puncture site in the TE puncture is too large

Back 35

the surgeon can cauterize it.

Front 36

patients who are candidates for the te puncture a __________ for prevention of ___________

Back 36

myotomy, pharyngospasm

Front 37

after total laryngectomies, patients do increase

Back 37

lingual pressures to compensate for the absence of the larynx and reduced pharyngeal wall function postoperatively

Front 38

ROM exercises should be done

Back 38

5-10 times daily for 10 min. each time at beginning of radiotherapy or at the beginning