耳鼻咽喉—头颈外科课件：Laryngeal tumour.ppt

Laryngealtumourbenign：papillomas hemangioma fibroma neuroinomaMalignant:

HPVaggressivehoarsnessdyspnea-childrecurrent-childmalignant-adultmulti-operationspapillomas

喉癌

Carcinomaoflarynx

epidemiology

1.distribution

2.incidenceaccountfor5.7-7.6%ofmaglinattumours,occupyfor7.9-35%ofENT

sex：male：female=1.9-6.8∶1

age：occurin50-70yearsold

Etiology

unclear,contributingfactors:

1.smoking

2.drinking

3.airpollution

4.viralinfection

5.sexhormone

6.precancerouslession

PathologySquamouscellscarcinoma-accountfor93-99%Adenocarcinoma,undifferentiatedcarcinoma-rareseen

Types1.Supraglottic2.glottic3.Subglottic4.ParaglotticFeatures60%30%6%PoordifferentiationRapidprogressEarlymetastasisWelldifferentiatedSlowprogressinLatemetastasisBetweenthetwotypesDifficulttodiscover

Metastasis

Ways:

1.immediateMetastasis

2.lymphaticmetastasis

3.hematogenousmetastasis

1.Immediatemetastasis

2.Lymphaticmetastasis

3hematogenousmetastasis

clinicalsymptoms1.supraglottic

pharyngealdiscomfort，foreignbodysensation,apttometastasis

2.glottic

symptoms:hoarsness,dyspnea,difficulttometastasis

3.subglottic

Symptom

Features：

1.hoarness

2.dysphagiaanddyspnea

3.oftennofindingsinlarynscope

4.oftennegativeresultinbiospy

5.invadethyroidcartilage4.paraglottic

Examination

1、Larynscope

Shape：Cauliflower,ulcer,nodula,mass

Supraglottic

Glottic

Subglottic

Paraglottic

2、neckexamination：

carotidlymphnodeenlargement?

laryngealbodyenlargement?

thyroidgland?

3、Imaging