Lecture 17 Laryngeal Cancer

Question 1

Who are more likely to get laryngeal cancer?

Answer 1

60-65 year old male smoker with moderate alcohol intake

Question 2

What are the causal/risk factors for laryngeal cancer?

Answer 2

smoking, alcohol, smoking & alcohol, environmental irritants, chemicals, smoking & asbestos

Question 3

What are the signs to laryngeal cancer?

Answer 3

primary perceptual: hoarseness but stridor, breathiness, rough, vocal effort, decr. vocal loudness

secondary perceptual: stridor, diff. breathing, coughing up blood, painful swallowing

SIGNS: lump in neck, tenderness in laryngeal area, lack of crepitation (creaking noise), fullness in CT & TH membrane

Question 4

What are 3 of 6 components of diagnoising laryngeal cancer?

Answer 4

-head and neck exam
-videostroboscopy
-CT scans and MRI
-Biopsy and histological analysis
-X Rays
Modified Barium Swallow

Question 5

What is the role of the SLP Pre-Op for laryngeal cancer?

Answer 5

*educate pt regarding surgery
*possible outcomes
*communication options post-surgery
*address pt. concerns
*assess cognitive status
*status of pt.’s hearing
etc.

Question 6

What is the role of the SLP Post-Op laryngeal cancer surgery?

Answer 6

*review pre-op discussion
*assess voice, speech, swallowing
*demo electronic speech aids
*teach use of oral type instrument
*discuss rehab. plans
*schedule meeting with other laryngectomee pt.

Question 7

What are the treatment options to laryngeal cancer?

Answer 7

radiation therapy

chemotherapy

surgery

surgery & radiation

Question 8

What are the side effects of radiation therapy?

Answer 8

*loss of salivary/mucous
*xerostomia
*muscle atrophy
*fibrosis of soft tissues
*keratosis
*edema & erythema
*dysphagia
*loss of taste
*tooth damage/tissue necrosis/mucositis/scar formationi

Question 9

What are the two types of alaryngeal speech devices?

Answer 9

Pneumatic & Electronic

i.e. Tokyo Speech Aid / Cooper Rand & Electrolarynx

Question 10

Describe the use of a pneumatic device

Answer 10

cup shape fits over stoma
small unit with reed to provide sound
tubing carries sound to mouth
*natural sounding easy to learn, inexpensive - Pro
*bulky, requires access to stoma - Con

Question 11

Describe the use of the electronic speech aid

Answer 11

oral device - vibrators delivers vibration to tube which is placed in mouth
sound is delivered to oral cavity and articulated
good post-surgery when neck is healing - PRO
$300 (con…maybe)

Question 12

Describe the use of the electric larynx

Answer 12

*neck held, battery operated
*switch activated
*pitch & volume control
*easy to use while learning esophageal speech - PRO

Question 13

What is TEP?

Answer 13

TEP is a surgical procedure where a small puncture is made thru the tracheal wall into the esophagus
*prosthesis is inserted that acts as a shunt to direct air into the esophagus
*air moves through PE segment, creating sound, and sound travels into pharynx, oral and nasal cavities is resonated and articulated