By Tim Price, Paul Montgomery, Martin Birchall, Patrick Gullane
Fresh advances in versatile endoscopy have ledto the improvement of the Trans-Nasal FlexibleLaryngo-Esophagoscope (TNLE) which makes visualisation,identification, biopsy and therapy of stipulations of theupper aero-digestive tract more uncomplicated and attainable underlocal anaesthesia in an outpatient setting.A designated and very important source for oncologists, otolaryngologists,gastroenterologists, respiration physicians, and ENT surgeons,Diagnostic Atlas of Tumors of the higher Aero-Digestive Tractbrings the reader updated with the right kind identificationand analysis for malignant affliction of the larynx, phary Read more...
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Additional resources for A diagnostic atlas of tumors of the upper aero-digestive tract: a transnasal video endoscopic approach
Thick arrows = thyroid cartilage. 8 Postcontrast axial CT scan at level of false cord. Pre- and paraglottic fat infiltration anteriorly crossing the midline and on the left. Extralaryngeal spread extending through thyroid cartilage anteriorly (arrows). Thick arrows = thyroid cartilage. , trachea, soft tissues of neck including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus, and styloglossus), strap muscles, thyroid, and esophagus T4b: Tumor invades prevertebral space or mediastinal structures, or encases the carotid artery.
Approximately 24,000 new cases are diagnosed annually in the United States with around 8000 annual deaths attributed to this disease. This accounts for 14–24% of all head and neck malignancies. The reported highest incidence is in India, where it accounts for 20–30% of all malignancies. Within the United Kingdom the incidence varies from 8 per 100,000 in the Thames 20 Investigations The clinical examination may need to be supplemented with an examination and biopsy under general anesthesia. This may be useful in order to delineate the extent of the primary and may reveal a second primary tumor.
A rim resection is performed if no involvement is apparent. Where definite invasion is seen, a segmental resection is performed. This is because of an intramedullary spread and a poor radio sensitivity of the involved bone. Accessing the primary site for confident resection may require a mandibulotomy. This is particularly useful for lateral and more posterior tongue tumors, but may also be useful in gaining access to the posterior floor of mouth and retromolar areas. Where tumors have extended into regional lymphatics in continuity resection may only be possible by mandibulotomy.