The epiglottis, a piece of cartilage that covers the larynx to keep food and other particles from entering the larynx while swallowing, is part of the larynx, or voice box. The larynx is divided into the glottis, supraglottic and subglottis, with the epiglottis being part of the supraglottis and the most common site for supraglottic cancer, lead author Andrew Mong of the Hospital of the University of Pennsylvania reported in the 2003 issue of the "American Journal of Roentgenology". Supraglottic cancer comprises 35 percent of laryngeal cancers, the Armenian Health Network reports. Treatment depends on the extent of cancer.
Laser Surgery
Removal of the tumor via endoscope using laser surgery works well for small squamous cell supraglottal tumors, the Merck Manual states. Squamous cell carcinoma makes up around 90 percent of cancers of the larynx, Merck also reports. Resection of just the tumor allows the patient to speak normally and swallow after surgery and requires no incision. Partial laryngectomy, with removal of one vocal cord, can also be done through endoscopy and laser, CancerResearch UK states.
Radiation
Around 50 percent of supraglottic tumors spread to the lymph nodes before diagnosis, lead author Samuel Beenken, M.D. reports on the Armenian Medical Network. Radiation of the tumor and the lymph nodes, sometimes in conjunction with chemotherapy using cisplatin, may prevent the need for total laryngectomy in patients with supraglottic tumors in as many as two-thirds of patients, Beenken adds.
Surgical Incision
Partial or complete removal of the larynx is used to treat larger tumors of the epiglottis, often in conjunction with radiation. Supraglottic laryngectomy spares most of the vocal cords, allowing normal speech. Supraglottic laryngectomy spares most of the vocal cords, allowing normal speech. Complete laryngectomy necessitates placement of a hole in the neck, called a tracheostomy, which will be permanently used for breathing after the surgery. Complete removal of the larynx also destroys the ability to speak normally and requires learning new ways of speaking. A person with a tracheostomy speaks using air taken into the esophagus, the tube that leads from the mouth to the stomach, or using an electrolarynx, a battery powered device which creates sound when held against the neck, the Merck Manual explains. Lymph nodes may also be removed from the neck, along with muscles and nerves, which can cause shoulder stiffness. The neck may also appear thinner and shrunken, CancerResearch UK states.
References
- Merck Manual: Laryngeal Cancers
- Armenian Medical Network: Laryngeal Cancer
- Abramson Cancer Center of the University of Pennsylvania: Laryngeal Cancer
- "American Journal of Roentgenology": Epiglottal Carcinoma As A cause of Laryngeal Penetration; Andrew Mong et al
- CancerResearchUK: Which Surgery for Laryngeal Cancer?
