1. Laryngeal Cancer
    • smoking
    • environmental irritants
    • chemicals
    • smoking and alcohol
    • smoking and asbestos
  2. Laryngeal cancer:

    Typical pt?
    Accounts for ___ of all cancers?
    50-70% of all laryngeal cancer deaths are associated with ___?
    alcohol and smoking incr risk by up to ___?
    60 y/o males heavy smoker w/mod alcohol intake



  3. Cancer Staging TNM numerical value represents severity

    T= location/size of primary tumor

    N= involvement of lymph node

    M= distant metastasis
  4. Tumor staging example T1N1M0 means?
    T1= tumor is confined to VFs

    N1= a single small lymph node involved

    M0= no metastasis
  5. Signs and symptoms laryngeal cancer

    Primary symptom?
  6. Signs and symptoms laryngeal cancer

    Additional symptoms?
    • stridor
    • diff breathing
    • pain
    • coughin
    • coughing up blood
    • swallowing problems
    • painful swallowing
  7. Signs and symptoms laryngeal cancer

    • lump in neck
    • tenderness in laryngeal area
    • lack of crepitation
    • fullness in CT & TH membrane
    • presence of lumps
    • lesions of VFs
  8. Pathophysiology

    Arises in ___, usually ___?

    Invades __ and destroys ___?

    Can invade____ and ___?
    epithelium, squamous cell carcinoma

    • tissue
    • normally functioning cells

    • layers of lamina propria
    • TA muscle
  9. Diagnostics

    Biopsy and histological analysis
  10. Diagnostics: Laryngeal cancer
    what is seen on videostrob?
    • extent of lesion greatly affects VF vibration
    • 1. VF appears stiff, immobile
    • 2. decreased mucosal wave
    • 3. decreased amplitude of vibration
  11. Acoustic signs:

    Increased freq and intensity perturbations

    increased noise levels
  12. Acoustic signs

    • increased airflow
    • increased subglottal pressure (Ps)
  13. Tx Options?
    • radiation therapy
    • surgery
    • surgery and radiation
    • chemotherapy
  14. Laryngectomy
    Procedure in which?
    can have?
    Extent depends on?
    all or part of the larynx is excised

    Total, hemi, partial, suprglottic

    depends on tumor size, location, invasiveness, and spread

    communication, swallowing, body image
  15. Role of SLP

    Pre-op consult?
    • educate pt regarding surgery
    • possible outcomes
    • communication options s/p
    • address pt concerns
    • assess cognitive status
    • status of pts hearing
    • hand writing
    • etc
  16. Role of SLP post-op consult?
    • review pre-op discussion
    • assess voice, speech, swallowing
    • demo electronic speech aids
    • teach use of oral type instrument
    • discuss rehab plans
    • schedule meeting w/ other laryngectomee pts.
  17. Alaryngeal Speech? (4)
    • pneumatic devices
    • electronic
    • esophageal speech
    • tracheoesphageal speech
  18. Pneumatic device?

    • cup shaped piese fits over the stoma
    • small unit w/ reed inside to provide sound
    • tubing carries sound to mouth
    • Adv: natural sounding, easy to learn, inexpensive
    • disadvantage:bulky requires access to stoma (soreness)
  19. Cooper Rand Electronic speech aid?
    Oral device- vibrator delivers vibration to tube which is placed in mouth

    sound is delivered to oral cavity and articulated

    good post-surgery when neck is healing

    $300.00 battery operated
  20. Electric larynx?
    • neck held, battery operated
    • switch activated
    • pitch and volume control
    • easy to use, can use while learning esophageal speech
    • some pts prefer this method
  21. Esophageal speech?

    • Air is injected from the mouth into esophagus via tongue & pharynx
    • As air is expelled the PE segment vibrates creating sound that is articulated in the mouth

    Advat: no external devices; sounds more natural; pitch and loudness control; no batteries; both hands are free

    • Dis: takes a long time to learn and master
    • must have great artic
    • not very loud in noise
  22. Tracheoesphageal puncture-TEP?
    is a surgical procedure in which a small puncture is made thru tracheal wall into esophagus

    prosthesis is then inserted that acts as a shunt to direct air into the esophagus

    air moves thru PE segment, creating sound, and sound travels into pharyns, oral & nasal cavities & is resonated and articulated
Card Set
Laryngeal cancer