Surgery for Laryngectomy Flashcards
Who identifies a tumor?
ENT- they also perform the surgery
What is the goal of cancer surgery?
To remove every single cancer cell. They often have “fingerlings” that grow everywhere. This makes it difficult to remove ALL the cancer.
What are healthy margins?
The ENT takes extra “healthy” tissue surrounding the tumor.
What can an ENT do if tumor threads are wrapped around nerves?
May have to leave it. What was otherwise done in surgery just buys time because the tumor will grow back.
Who examines the tumor post-op?
Pathologist examines and checks for clean margins
What are the complications that come with radiation?
- if you had pre-surgery rad, you cannot get post-surgery rad
- makes healing difficult, prolongs it
- pre-surgery rad affects healing of pharyngeal tissue, can develop a “leak” where food can rot- very, very bad
- post-surgery rad affects speech, toughens tissue, disables vibration
What is an exophitic tumor?
protruding, can be seen under the skin
Total Laryngectomy
includes removal of:
hyoid bone
laryngeal cartilages
1 or 2 (or up to 4) rings of the trachea
Total Laryngectomy + Glossectomy
includes removal of: tongue part of jaw hyoid bone muscles (suprahyoid, mylohyoid, infrahyoid) laryngeal cartilages ring of trachea (1-4) part of neck
What might a patient need if a lot of neck tissue must e removed?
Pectoral Flap
May even take muscle from forearm or thigh to that the neck has muscular support to hold up their head
What might a patient need if a lot of neck tissue must be removed?
Pectoral Flap
May even take muscle from forearm or thigh to that the neck has muscular support to hold up their head
Partial Laryngectomy
crack thyroid cartilage
Hemi- remove half (vertical or horizontal)
Horizontal: usually supraglottal removed, VF may remain
-not often done (higher rate of cancer return, still have loss of function)
What is a hot knife?
What is a cold knife?
electrified scalpel that cuts and cauterizes simultaneously
-thyroid gland needs to be constricted
-larger blood vessels need to be ligatured (Von Langenbeck technique)
Cold knife: regular scalpel
Post-surgical outcome
Patient will never breathe through nose or mouth again no blowing nose no coughing no whispering PHARYNX ONLY LEADS TO ESOPHAGUS
Cardiac Sphincter
Lower Esophageal Sphincter (LES), reacts to liquid to keep in stomach
