3/10- Surgery Flashcards
Who developed the T incision?
Von Langenbeck
What is so important to do during surgery?
- remove every single cancer cell. If you leave one single cell there will be reproduction because it will rapidly reproduce. It is not normal so it won’t die on its own.- Go to clean borders/healthy margins. You must cut into healthy tissue to be sure you have all the cancer cells
Who can perform a laryngectomy?
Surgeon, ENT, Otolaryngologist
What is exofittic?
Classification- a tumor that is protruding, you can identify the lump (i.e., exofittic breast tumor).
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the less tissue that is removed, full recovery is more likely
false. You might not get all the cancer.
What is the downfall (in regards to your larynx) to only doing a lumpectomy
Patients will choose a lumpectomy over a laryngectomy, but if you only remove the lump the larynx isn’t going to work. it will not work for voicing, and it will not fulfill its primary biological function.
What is the biological function of the larynx?
protection of the airway
What occurs when the tissue is removed during a cancer surgery?
the tissue is rushed to a pathologist who will do an onsite inspection and look for cancer on the edges of the tissue that has been removed. If the pathologist says the edges are clean they they close the patient up. If not, the surgeon will take out even more, or the patient will go to radiation therapy.
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If the patient has pre-surgery radiation, there will not be post surgery radiation?
true
It’s all about the dosage amounts (gys)
Why is a T incision so widely used?
maximum opening of tissue and exposure of the structures that need to be inspected without doing more cuts.
If a total laryngectomy is performed, what is removed?
From the hyoid bone to the trachea (first 2-4 rings) (sometimes the tongue can be resected/removed)
How long does the surgery take?
3-5 hours
Review pictures in surgery notes
.
Why are the pharyngeal constrictors removed?
Because of their attachment to cricoid and thyroid cartilages. The inferior constrictor makes a half circle on the posterior aspect of the larynx, it is attached to the thyroid cartilage. After the larynx is removed the inferior constrictor will be tied to itself and be brought around to make a whole circle.
What are issues with a cordectomy?
The larynx won’t work. Not a high cure rate. Cancer cells seem to be left
What is a hemilaryngectomy?
Taking out 1/2 of the larynx
What is a supraglottic laryngectomy?
Horizontal cut
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there are many combination for cuts and surgery types?
true1/4 of it, 1/2 of it. vertically or horizontally cut. The main issue is the larynx isn’t going to work
What is the muscle that is used for the upper esophageal sphincter (UES)?
cricopharyngeus
If the cricopharyngeus remains in tact, what are the person’s chances of using some esophageal speech?
Good. If all the cricopharyngus is removed with the laryngectomy than there is no chance at all.
What are the two sphincters of the esophagus?
upper esophageal sphincter (UES) and lower esophageal sphincter (LES)
A sphincter is in a…?
constant state of contraction
What is the purpose of the UES?
To keep air out of the esophagus therefor the stomach
What is the purpose of the LES?
keep stomach acid and food you just swallowed from coming back up again