Head and Neck Cancer Flashcards
(49 cards)
Tumor Classification
TNM system. Numbers used to categorize tumors.
What is the “T” in TNM
tumor size and extension into neighboring tissue.
What is the “N” in TNM
nodes. How far or if cancer spread into lymph nodes
What is the M in TNM
Spread of cancer to other organ systems within the body
What is typical course of treatment
surgery.
When does speech and swallow therapy begin after surgery?
10-14 days post
When does Radiation and Chemo begin?
4-6 weeks post.
When do functions begin to deteriorate during radiation?
Swallowing function dleclines 4 weeks in. Overall health also declines. Many drop out at this time. HOME PROGRAMS IMPORTANT HERE BECAUSE EVEN IF TOO SICK TO COME TO THERAPY CAN DO SOME THINGS AT HOME. Then can come back when feel better.
What is important in pre-tretment counseling
Establish baseline of function.
Preliminary swallow screen of VFSS for pre and post surgery comparison.
Dental consultation for removing parts of jaw or teeth.
Psychosocial assessment- assess how well will adjust after surgery.
What’s the purpose of pre-treatment counsleing
Reduce patient and families fear
Don’t try to provide exact details of post-treatment function.
Explain speech and swallowing impact
Assure them the team will be avilable to improve post treatment function
Explain patient will be responsible for their own rehab
When does post treatment intervention start
2-3 days post.
PRovide counseling to patient and family.
1-2 weeks post: healing is progressing so re-evaluate patient and begin rehab
How do we do a swallow re-ealuation
VFSS
Continue rehab through radiation therapy. IF too sick encourage ROM excercises as much as possible.
What’s a primary closure
soft tissues remaining in the area sutured together to cloe defect.
Used with small resections.
Can’t be used if natural tension in tissues would be too great, which would reopen wound
What’s a Flap Reconstruction
Tissue elevated away from its normal site.
One portion attached to donor site, so blood flow to flap until healing is complete
Other portion is attached to the defect area.
What is a graft?
usually from a part of your body that can easily grow skin.
move tissue from distal part of body to oral cavity.
Attaceh arteries and veins in donor tissue to arteries and veins in defect area to provide blood supply.
What is Post-treatment surgery dependent on
surgical site and extent of surgery and type of resection.
primary closure=best function
What do we need to read if we’re treating patients who’ve had surgery
detailed description of surgery and resection, include exact structures were involved. In surgical report in patient chart!
What is a partial glossectomy?
removal of <50% of tongue.
Difficulty with bolus hold and prep for swallow
What is a partial glossectomy?
removal of <50% of tongue.
Difficulty with bolus hold and prep for swallow
What is total glossectomy?
remove >50% of tongue.
Difficulty moving material from oral caity.
Reduced tongue driving force
REduced pharyngeal clearance
What happens with Anterior/Lateral Floor of Mouth Resection?
reduced anteriror tongue range
inability to lateralize tongue
REDUCED HYOLARYNGEAL excursion
Reduced UES opening
What’s a palatal resection?
Remove >50% of soft palate
incomplete VP closure=nasal regurtitation
What does a base of tongue resection impact?
difficulty with bolus control, reduced driving force for bolus (tongue base retraction)
Delayed swallow trigger
What’s a supraglottic laryngectomy (horizontal laryngectomy) used for?
Small lesions involving supraglottic structures; epiglottis, aryepiglottic folds, ventricular folds
Remove all/part of: hyoid, epiglottis, aryepiglottic folds and false v folds.
NO VALLECULAE, SMALL PYRIFORM SINUS
