The larynx, also known as the voice box, is found at the back of the throat, in front of the windpipe (trachea). It contains three distinct regions:
When air is exhaled against the true vocal cords, they vibrate and create sounds.
Cancer of the larynx, also known as laryngeal cancer, is a type of cancer that develops inside the tissue of the larynx.
Common symptoms of laryngeal cancer include:
- unexplained changes in the voice, such as sounding hoarse or husky
- pain when swallowing
Cancer of the larynx strikes approximately 12,000 persons in the United States each year and causes 3,800 deaths. The average age of these patients is 63. Almost all those who develop cancer of the larynx use or have used tobacco and many are also heavy drinkers of alcohol.
Alcohol and tobacco
Evidence shows that alcohol and tobacco are the two biggest risk factors for laryngeal cancer.
Diagnosing laryngeal cancer
Physical exam of the throat and neck: An exam to check the throat and neck for abnormal areas. The neck will be felt for swollen lymph nodes. A history of the patient’s health habits and past illnesses and medical treatments will also be taken.
Laryngoscopy: A procedure to look at the larynx (voice box) for abnormal areas. A mirror or a laryngoscope is inserted through the mouth to see the larynx. A special tool on the laryngoscope may be used to remove samples of tissue (biopsy).
Endoscopy: A procedure to look at organs and tissues inside the body, such as the throat, esophagus, and trachea to check for abnormal areas. An endoscope is inserted through an opening in the body, such as the mouth. A special tool on the endoscope may be used to remove samples of tissue (biopsy).
There are two types of surgery that are used to treat laryngeal cancer. They are:
- partial laryngectomy
- total laryngectomy
The operation involves surgically removing the affected part of the larynx. Some of vocal cords will be left in place so that patient will still be able to talk, but his voice may be quite hoarse. The patient should be under strict control after the surgery and have regular check ups. Also, it is possible if the tumor did not spread and at early stages otherwise the total laryngectomy is recommended.
A total laryngectomy is usually used to treat advanced stage three or stage four laryngeal cancers. The operation involves removing entire larynx. Nearby lymph nodes may also need to be removed if the cancer has spread to them.
As patient’s vocal cords will be removed, he won't be able to speak in the usual way. There are several ways to help restore patient’s speech. If patient have a total laryngectomy, he will also need to have a permanent tracheostomy. The tube will usually be removed after a few weeks, leaving the hole. The medical term for a surgically created hole in the skin is a stoma.
Recovery from laryngeal cancer
If patient have had some, or all, of his larynx removed (laryngectomy), it's likely that he will need to spend one or two days in an intensive care unit (ICU) until your body has recovered from the effects of the surgery.
He won't be able to eat until his throat has healed, which for most people is between 7 and 14 days. During this time, he will need to be fed with a tube that's placed down his nose and into his stomach. However, in a small number of people, recovery can take several months.
Patient will be given training about how to keep his stoma clean. Also in National Oncology Center of Azerbaijan in Head and Neck Department the Provox (Voice Prosthesis) is used which helps the patient to speak and usually patients are very satisfied.
The Provox voice rehabilitation system
- The glottis, consisting of two bands of tissue known as the true vocal cords.
- The supraglottis, a larger area above the true vocal cords that contains several folds of tissue, including the bulkier false vocal cords; and
- The subglottis, a small compartment connecting the vocal cords and the windpipe.
The Provox® voice prosthesis is an indwelling device for prosthetic voice rehabilitation after total laryngectomy. The device is inserted in a tracheoesophageal (TE) fistula (a passage created between the windpipe and gullet). Speech is obtained by closure of the tracheostoma with a finger and exhaling. The valve opens under this positive pressure, leading air into the gullet, where the sound is produced for speech.