耳鼻咽喉头颈科-喉癌(英文).pptx

Carcinoma of Larynx OutlineEpidemiology: 2-5% of all carcinoma15-20% of head and neck cancers80% in 50-70 year-old age groupOutlineA high incidence in men and smokersA high incidence in north-east ChinaAnatomy of LarynxPicture of Laryngoscopy Anatomy of LarynxSkeletonHyoid boneEpiglottic cartilageThyroid cartilageCricoid cartilageArytenoid Anatomy of LarynxAnatomy of LarynxEtiologyNo definite causes known, possible risk factors1. Smoking Almost all patients with laryngeal carcinoma have a long history of heave smoking; Excessive Alcohol intake exerts a synergic effect with smokingEtiologyOver 90% of laryngeal cancers are caused by smoking.Lung Cancer:??Smoking causes 87% of all lung cancer cases.??Etiology2. Environment pollution: Chemical factors, Air pollution3. Human papilloma virus（HPV）infection might be associated with laryngeal carcinoma.Etiology4. Influence of sexual hormone suggested by the marked predominance of male over female in the incidence;Etiology5. longstanding inflammationespecially those in the form of hypertrophic laryngitis and vocal cord leukoplakia and keratosis(precancerous lesions).PathologyPathologically more than 90% of laryngeal cancer is well differentiated squamous carcinoma, adenocarcinoma very rare,symptoms and signs1. Hoarseness, (early in glottic carcinoma)2. A vague sensation of a lump in the throat, (supraglottic carcinoma)3. Dyspnea, (advanced stage T3 or T4)4. Sore throat and dysphagia, referred otalgia, (carcinoma with ulceration)Classification and Clinical FeaturesAccording to anatomic-clinically classified into three typesGlottic carcinoma: the commonest type (60-70%) . It arises on the vocal cord or on the anterior commissure.Classification and Clinical FeaturesClassification and Clinical FeaturesClassification and Clinical FeaturesFeatures Glottic carcinoma1. Usually unilateral true cord,2. Early hoarseness, may lead to early recognition3. It often causes progressive laryngeal obstruction accompanied by inspiratory s