About 1% to 5% of laryngeal cancer patients in China gave up the opportunity for surgery because they couldn’t bear the inability to speak and speak. April 16, 2022 is the 20th “World Voice Day”. Professor Xiao Xuping, Director of Otolaryngology, Head and Neck Surgery, Hunan Provincial People’s Hospital, reminded that after total laryngectomy, esophagus pronunciation, artificial larynx, electronic larynx, and esophagotracheostomy can be used. Don’t give up the opportunity for surgery while you wait for speech reconstruction.
Mr. Li, a 72-year-old from Ningbo, Zhejiang, started smoking and drinking in his 20s. When he was middle-aged, he would drink 1 catty of liquor and smoke 2 packs of cigarettes almost every day. I started to have hoarseness 8 years ago. I thought it was chronic pharyngitis. After taking a lot of medicine, it didn’t help. After going to the hospital for examination, I was told that it was “throat cancer”!
Thinking of not being able to speak normally after the operation and leaving a permanent hole in his neck, Mr. Li rejected the doctor’s suggestion of a total laryngectomy. After being discharged from the hospital, his breathing difficulties and suffocation became more and more serious. He had to be re-hospitalized a month later and underwent a total laryngectomy.
After the operation, because he could not speak, he could only communicate with people by writing or gestures. Communicate with people and gradually close yourself. Since then, he has been pondering how to make a normal voice every day, and after 3 years, he succeeded in speaking with the artificial throat device, which made him ecstatic.
In order to help more total laryngectomies return to the “sound” world, he established a WeChat group to encourage each other with people without throats from all over the country, and exchanged experience in learning artificial electronic throat, esophagus and other pronunciations. Everyone also often gathers to sing and communicate… Professor Xiao Xuping, Director of Otolaryngology Head and Neck Surgery of Hunan Provincial People’s Hospital, and other experts also provide treatment advice and voice guidance for everyone in the group, and encourage patients after laryngeal cancer surgery to regain their “new voice”.
April 16, 2022 is the 20th “World Voice Day”. Professor Xiao Xuping, director of the Department of Otolaryngology and Head and Neck Surgery at Hunan Provincial People’s Hospital, introduced that laryngeal cancer is a common malignant tumor of the head and neck, with an incidence of about It is 1 in 100,000, accounting for 2.1% of systemic malignant tumors and 13.9% of head and neck tumors. Although the overall incidence is not high, the incidence of laryngeal cancer has shown an overall upward trend in recent years.
“There are more male patients with laryngeal cancer than females”, Xiao Xuping said, this is related to hormones, male lifestyle, smoking and drinking habits and other bad habits; at the same time, the incidence of laryngeal cancer is more in the north than in the region The characteristics of the south, “this is mainly related to the drinking and environmental pollution in the north in winter”.
According to data, about 1% to 5% of laryngeal cancer patients in my country give up the opportunity for surgery because they are worried that they will not be able to speak after surgery. In this regard, Xiao Xuping emphasized that early laryngeal cancer does not require total laryngectomy, and most of them only require minimally invasive peroral surgery, and most of the pronunciation can be restored after surgery. Even if total laryngectomy is performed for advanced laryngeal cancer, the following methods can be used to reconstruct speech and restore some language functions:
1. Esophageal pronunciation method: After training, the air swallowed into the esophagus is removed from the esophagus. It rushes out to produce sound, which is then regulated by the pharyngeal cavity and oral cavity to form language. The disadvantage is that the pronunciation is intermittent and cannot speak too long sentences.
2. Artificial larynx: The airflow during exhalation is guided from the trachea to the oral cavity, and at the same time, it impacts the rubber membrane to make pronunciation, and then adjusts through the oral cavity to form a language. The disadvantage is that it is inconvenient to wear and carry.
3. Electronic larynx: use the audio oscillator to make a continuous sound, place it on the patient’s chin or neck to make a speech action, and then the sound can be produced. The disadvantage is that the sound produced is unnatural.
4. Esophagotracheostomy: a fistula is made between the posterior wall of the trachea and the anterior wall of the esophagus, and a pronunciation button or a muscle-mucosal flap is inserted to sew into a tube to form a language.
Early symptoms of laryngeal cancer:
hoarseness that has not been relieved for more than half a month; unexplained foreign body sensation in the throat, sore throat, symptomatic treatment is ineffective; labored breathing, Painless lump in neck; blood in sputum, no abnormality on pulmonary examination.
Xiao Xuping said that laryngeal cancer is divided into glottic type, supraglottic type and subglottic type. The former is easy to be taken seriously due to the early appearance of hoarseness, while the latter two have less obvious early symptoms, mostly throat foreign body sensation , sore throat, easy to be misdiagnosed as pharyngitis.
Laryngeal cancer prevention and treatment:
1. Stay away from tobacco and alcohol;
2. Eat less pickles, bacon and other pickled meats prepared and smoked food;
3. Do not stay in the air pollution environment for a long time, pay attention to protection from smog;
4. Adult male hoarseness for more than 15 days should go to Regular hospital ENT specialist examination, to achieve early detection and early treatment.
Xiaoxiang Morning News reporter Xia Sheng correspondent Liang Hui Liu Xiaobai Yuan Kanglong