In the surgical treatment of laryngeal cancer , we must consider the preservation of life, while saving as much as possible the problem.Surgical treatment of laryngeal cancer more than in the past for the total laryngectomy, in recent years has been the emergence of a variety of preservation and restoration of laryngeal function in surgical techniques, mainly in the following ways:
1. Surgery by direct laryngoscopy
For smaller tumors or carcinoma in situ treatment, such as the tip of the epiglottis tumor resection, the limitations of vocal cord tumor resection or fulguration and so on. In recent years, also carried out by direct laryngoscopy, as specified under the operating microscope laryngeal resection of the tumor.
2. Partial laryngectomy
By surgical partial laryngectomy to remove the tumor and only part of throat structure, maintaining a normal or physiological function. There are four kinds of general surgical procedures:
(1) vocal <or a room with> the side of resection vocal cord resection surgery, retention of cartilage-like structure, which preserves normal laryngeal function.
(2) vertical partial laryngectomy surgery removed the side of the laryngeal tissues, usually including the side of the thyroid cartilage, and attached to the wing flap on the side of a very vocal and chamber within the zone, when necessary, including the ipsilateral arytenoid cartilage.
(3) the level of partial laryngectomy in laryngeal resection of bilateral room with room above, epiglottis, epiglottis structure and will take part of the celebration before the clearance organization, if necessary, cartilage-like fashion with resectable side of the structure.
(4) before the joint operation of the former joint ligament attached to the thyroid cartilage directly, so easy before the joint at the cancer invasion and cartilage. Anterior surgery for vocal cord cancer has not invaded the side of the posterior ipsilateral, contralateral vocal cord a little involvement from the front, both sides of the vocal cord movement normal subglottic cancer District violated a maximum of lcm, not invading the cricothyroid membrane.
3. Laryngectomy
Total laryngectomy surgery removed all of laryngeal cartilage and soft tissues. If the tumor has invaded through the cartilage, all still need to remove the side of the strap muscles and the ipsilateral thyroid gland. Mainly applies to:
fixed vocal glottic carcinoma, or cancer has reached the posterior wall of the glottis.
down violations of glottic carcinoma than lcm, or of the cricothyroid membrane.
Surgical treatment of laryngeal supraglottic cancer violations of the epiglottis and tongue before the gap.
supraglottic laryngeal cancer violations, the destruction of cartilage and neck soft tissue.
fibrosarcoma not sensitive to radiation, etc.