#常德头条 ##石门县中医医院#
Recently, the Department of Eye, Otolaryngology and Laryngolaryngeology of Shimen County Hospital of Traditional Chinese Medicine successfully completed the first case of partial laryngectomy + laryngeal function reconstruction + tracheostomy + cervical lymph node dissection. The operation is difficult, has extremely high anatomical requirements, preserves the patient's laryngeal function during the operation, and the patient's quality of life is very high after surgery, and the effect of radical cure is achieved.
On the same day, Dr. Wang Yi was on duty at the ENT outpatient clinic, and 70-year-old Uncle Li (pseudonym) came to the outpatient clinic in a hurry, saying that he had been hoarse for a year and a half, and that the symptoms of hoarseness had been significantly worse recently, and he had difficulty speaking, and he was short of breath after activities.
Dr. Wang Yi patiently inquired about the situation and learned that Uncle Li usually likes to drink bulk liquor and smokes at least 2 packs a day, and this time he has been treated as a cold in the clinic after his hoarseness, but it has not been relieved, and now the symptoms are aggravated, so he came to the otolaryngology clinic of Shimen County Hospital of Traditional Chinese Medicine under the persuasion of his family.
After Dr. Wang Yi perfected the electronic rhinolaryngoscopy, he saw that the right vocal cord had a pale red cauliflower-like neocreature that protruded into the laryngeal cavity, and the preliminary diagnosis was that "the nature of the laryngeal neoorganism is to be determined".
"Uncle Li, the reason for your hoarseness is that there is something on your vocal cords, which may require hospitalization, if the pathological nature is not very good, you may also have to make an incision from the outside of the neck to completely remove the lump" Dr. Wang Yi patiently explained, "Is it so serious? Dr. Wang, are you scaring me?" Uncle Li questioned.
After repeated communication between Dr. Wang Yi, Uncle Li and his family, he went through the hospitalization procedures.
After Uncle Li was hospitalized, in order to further clarify his condition, he continued to improve the rapid biopsy of laryngeal masses under laryngoscopy, and pathological findings showed that invasive squamous cell carcinoma, intermediate-well-differentiated squamous cell carcinoma.
Sure enough, Uncle Li's hoarseness this time was indeed caused by laryngeal cancer.
Seeing the results, Uncle Li regretted it and did not come to the hospital for examination as soon as possible. After Uncle Li learned about his condition, he actively cooperated with the doctor for treatment.
Under the auspices of Director Li Guo of the Department of Otolaryngology, the general practitioner conducted repeated preoperative discussions on Uncle Li's condition, considering that the patient's condition is more serious and older, in order to improve the patient's postoperative quality of life and preserve the vocal function, in accordance with the domestic laryngeal cancer diagnosis and treatment guidelines, a professional and safe treatment plan was formulated for him, and after full communication with the patient's family, it was finally decided to perform "partial laryngectomy + laryngeal function reconstruction + tracheostomy +". Cervical lymph node dissection".
Contraindications to surgery were ruled out, and after full preoperative evaluation and preparation, the ENT team successfully completed the operation after more than 3 hours under the escort of the anesthesiology department.
After the operation, the otolaryngology medical team provided accurate rehabilitation treatment for the patient, actively provided anti-infection, anti-inflammatory and swelling reduction, fluid rehydration, nutritional support, dressing change and various channel care measures, and cooperated with the characteristic treatment of traditional Chinese medicine, the patient recovered well and was discharged after half a month.
In this operation, the diseased larynx was resected, the laryngeal function was repaired by cricoglottis anastomosis, and the functional cervical lymph node dissection was performed, and the tube was sealed after 1 month after the operation, and the normal breathing, pronunciation and swallowing functions were completely restored.
1. What is laryngeal cancer?
The larynx is the articulatory organ of the human body, which is composed of three parts: glottis, supraglottic and subglottic. The vocal cords belong to the glottal area, and the epiglottis belongs to the supraglottic region, and the epiglottis is responsible for closing the larynx and preventing food from falling into the trachea. Laryngeal cancer is a malignant tumor that occurs in the larynx.
The symptoms of laryngeal cancer on the vocal cords are obvious, and hoarseness occurs at an early stage.
The tumor grows on or below the glottis, and the early symptoms are not obvious, or it is manifested as hoarseness, foreign body sensation, cough, etc., and after the tumor grows, it may cause dyspnea, excessive cough, difficulty swallowing food, neck pain or swelling, etc.
In advanced stages, metastases may occur through the lymph nodes. Treatment is mainly surgery, but radiation therapy can also be used.
2. Which specific groups of people are at high risk of laryngeal cancer?
1. Some occupations are exposed to carcinogens, such as long-term exposure to asbestos, nickel, and mustard gas;
2. People who live in areas with high air pollution for a long time;
3. People infected with human papillomavirus (HPV);
4. Have a bad habit of irritating the larynx for a long time, mainly referring to people who smoke and drink alcohol.
Laryngeal cancer is a tumor with a relatively good prognosis, with a survival rate of up to 70%. About 70% of patients with laryngeal cancer can be preserved by surgery. The earlier the lesion is detected, the better the laryngeal function is preserved, and the greater the likelihood of long-term survival.
3. How to prevent laryngeal cancer?
1. Timely diagnosis and treatment of vocal cord leukoplakia, severe dysplasia of squamous epithelium and adult laryngeal papilloma.
2. If there are symptoms of unexplained hoarseness and dyspnea, seek medical attention in time.
3. Quit smoking and drinking.
4. Avoid long-term exposure to dust and serious air pollution.
5. Maintain emotional stability, avoid or reduce the generation of bad emotions such as anger, sadness, and depression.
6. Have a family history and should have regular physical examinations.
Hunan Medical Chat Special Author: Shimen County Hospital of Traditional Chinese Medicine Wang Yi Literature and Art
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(Editor ZS)