Download A diagnostic atlas of tumors of the upper aero-digestive by Tim Price, Paul Montgomery, Martin Birchall, Patrick Gullane PDF

Oncology

By Tim Price, Paul Montgomery, Martin Birchall, Patrick Gullane

Contemporary advances in versatile endoscopy have ledto the improvement of the Trans-Nasal FlexibleLaryngo-Esophagoscope (TNLE) which makes visualisation,identification, biopsy and therapy of stipulations of theupper aero-digestive tract more uncomplicated and attainable underlocal anaesthesia in an outpatient setting.A exact and very important source for oncologists, otolaryngologists,gastroenterologists, breathing physicians, and ENT Read more...

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Extra resources for A diagnostic atlas of tumors of the upper aero-digestive tract: a transnasal video endoscopic approach

Sample text

Up to 70% of patients can have advanced disease at presentation and the incidence of occult cervical lymph-node metastases is linked to T stage and can range from 20% in T1/T2 tumors to 50% in T3/T4 tumors. The primary echelons of nodal drainage of supraglottic tumors are of levels II, III and IV. node involvement but this may be underestimated clinically. Clinical examination should include palpation of the tongue base. Endoscopic assessment is required together with adequate biopsies Figs. 6.

6. IMAGING A chest radiograph should be undertaken to exclude a lung primary or metastases; if metastases are shown or if suspicion is high, then a CT scan of the chest is warranted. Imaging studies help to define the spread of the disease into the pre-epiglottic EPIDEMIOLOGY Supraglottic tumors account for between 27% and 31% of all laryngeal cancers in the United Kingdom and United States of America. In France, Spain, and India the incidence is higher, between 60% and 70%, probably due to different carcinogens.

The cricoid cartilage is involved early, as there is no intervening muscular layer to protect the cricoid. Partial or complete fixation of one or both vocal folds is common due to submucosal spread, superiorly, through the conus elasticus and can make differentiation between a true subglottic tumor and spread from a glottic tumor difficult. The hypopharynx and esophagus may be involved by posterior spread beneath the cricoid cartilage. Early stage T1 and T2 tumors are not common, around 20% of cases, but if found, usually do not have nodal disease.

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