Surgery Flashcards
How is the PE segment innervated in normals? In laryngectomees?
.
What is surgically removed in a typical total laryngectomy?
Arytenoids Thyroid Cricoid and 2 tracheal rings True and false vocal cords Epiglottis Hyoid All intrinsic muscles except except cricopharyngeus May have neck dissection (scraping) .
What is a hemilaryngectomy?
Vertical.
1/2 of thyroid lamina, sometimes part of the cricoid, a true and false vocal cord, Arytenoid, left or right of the thyroid
For cancers of the glottis
What is a supraglottal laryngectomy?
Horizontal. Thyroid cartilage above the ventricle Epiglottis Aryepiglottic fold Hyoid bone Risky because it can cause dysphagia All subtotal surgery has chance of recurring cancer
What activities are precluded by laryngectomy and why?
.
What is a near-total laryngectomy?
Leaves one Arytenoid intact with nerves to allow it to rotate and contact to formed tissue and produce voice; Stoma used to communicate. Treated the same as other TE shunt patients to learn esophageal speech.
What are the major advantages/disadvantages of conservation surgery?
Advantages: retain natural airway, MAY have a better voice than a laryngeal speaker, reduced impact on QOL.
Disadvantages: lower cure rate, especially when lymph nodes are involved, dysphagia.
Do you think that laryngeal transplants will become common place? Why or why not?
No, because of needed surgeon skill, price of the surgery, finding a transplant, need immunosuppressive drugs because it is a soft tissue transplant, insurance doesn’t pay for it, too risky for age of population, depends on etiology.
