Clinical course of laryngeal cancer

May 08, 2018 11:00 | Symptoms And Treatment
In case of defeat of the vocal cords, the main and early symptom is persistent hoarseness of one degree or another, which increases with the size of the tumor and goes into aphonia. Infiltration of the anterior commissure is often accompanied by a cough. When the tumor spreads into the thickness of the fold or involves the process of arytenoid cartilage, immobility of one of the halves of the larynx sets in. This causes not only hoarseness, but also difficulty breathing, choking and coughing during meals. When laryngoscopy in the area of ​​the vocal fold is determined by a tumor, either protruding into the laryngeal lumen, or infiltrating fold. The surface of the tumor can be ulcerated, which is especially common in infiltrative forms of the tumor. Tumors of the vocal folds, as a rule, are diagnosed quite early, as the above symptoms appear even with small lesions.

With the localization of cancer in the lower larynx, the initial symptom of the disease is difficulty breathing, since this part of the larynx is the narrowest and the tumor even with small dimensions interferes with breathing. Later, with increasing tumor size and moving it to the vocal fold, hoarseness joins. The latter is especially pronounced in cases of deep infiltration of the underlying tissues and immobility of the affected half of the larynx. Characteristic for the laryngological picture of tumors of this localization is a tuberous infiltrate without clear boundaries, usually one-sided, often with ulceration, located most often in the anterior larynx.

With increasing tumor size, there are common symptoms of laryngeal cancer common to all localizations, such as a cough with a significant amount of sputum, sometimes with a trace of blood in it, putrid odor from the mouth due to disintegration and infection of the tumor. There may be bleeding. With extensive tumor lesions, the configuration of the cartilage of the larynx can change. There is a smoothness of their contours in connection with involvement in the tumor process and the attachment of inflammatory phenomena. When the tumor spreads to the posterior parts of the larynx, the symptom of slip or crepitation of the larynx disappears from the spine.

In later terms, there are constant pains with irradiation in one or both ears. Pain sensations are often associated with the act of swallowing and depend on the mechanical stimulation of the tumor, and also on the movements of the larynx when swallowing. Especially great suffering causes the patient a tumor with significant infiltration of underlying tissues and deep ulceration. The presence of a common cancer of the larynx leads always to one degree or another of the violation of the act of swallowing with the ingestion of food and saliva into the respiratory tract.