Cancer of the Larynx
happens more in males, potentially curable if detected early
Risk factors include:
Tobacco, and ETOH use
Voice abuse
Chronic laryngitis
Carcinogen exposure
Symptoms
Glottis- hoarseness
Suparglottis- pain with hot drinks/OJ dysphagia, sore throat, ear ache, lymphadenopathy
Subglottic is rare
Dx
History, larngoscpoy, indirect and direct
Treatment,
Radation, surgery, chemo
Types of surgery
Hemilaryngectomy- voice quality is adequate, temporary trach
Total laryngectomy, permanent trach, artifical speech
Total l laryngectomy with radical neck dissection
Alternative communication methods
Esophageal speech, good for only short segments of speech… belching
Electolaryngeal- mechanical device external
Tracheo-esophageal- most closely resembles normal speech
Nursing care after laryngectomy
Semi-fowler/fowler’s positioning
Use opioids cautiously, tcdb
Suctioning prn
Change in taste and smell
Alterations in Respiration
Deviated Septum- may result from trauma or be congenital
Nasal fracture- can cause airway obstruction or deformity
Need immed attention or a delay in treatment will happen due to swelling
Treatment of both the deviated septum and nasal fracture
Rhiniplasty- under local anesthesia, splint removed after 3-5 days, may take up to a year to heal
Prevent hemorrhage,
Maintain patent airway,
Other disorders of the nose
Obstrctions- remove if able
Epistaxis (nose bleed) rarely life- threatening
Treatment- direct pressure, sit and lean forward may be cauterized or packed
Obstructive sleep apnea (OSA)
Risk factors- male, older in age, smoking, overweight, snoring ,ETOH, sedatives
Symptoms- daytime sleepiness, mooring HA, sore throat, intellectual deterioration, personality changes, restless sleep, snoring,
Causes, reduced diameter of upper airway,
Reduced pharyngeal muscle tone
Treatment- CPAP lose weight, Surgery, traceostomy used only at night