Inspection Of The Party Wall In Cases Of Suspected Laryngeal Malignancy


Categories: BRONCHOSCOPY IN MALIGNANT GROWTHS OF THE TRACHEA
Sources: A Manual Of Peroral Endoscopy And Laryngeal Surgery

When taking a specimen the party wall should be

inspected by passing a laryngoscope or, if necessary, an esophageal

speculum down through the laryngopharynx and beyond the

cricopharyngeus. If this region shows infiltration, all hope of cure

by operation, however radical, should be abandoned.



Radium and the therapeutic roentgenray have given good results, but

not such as would warrant their exclusive use in any case of

malignancy in the larynx operable by laryngofissure. With inoperable

cases, excellent palliative results are obtained. In some cases an

almost complete disappearance of the growth has occurred, but

ultimately there has been recurrence. The method of application of the

radium, dosage, and its screening, are best determined by the

radiologist in consultation with the laryngologist. Radium may be

applied externally to the neck, or suspended in the larynx;

radium-containing needles may be buried in the growth, or the

emanations, imprisoned in glass pearls or capillary tubes, may be

inserted deeply into the growth by means of a small trocar and

cannula. For all of these procedures direct laryngoscopy affords a

ready means of accurate application. Tracheotomy is necessary however,

because of the reactionary swelling, which may be so great as to close

completely the narrowed glottic chink. Where this is the case, the

endolaryngeal application of the radium may be made by inserting the

container through the tracheotomic wound, and anchoring it to the

cannula.



The author is much impressed with Freer's method of radiation from the

pyriform sinus in such cases as those in which external radiation

alone is deemed insufficient.



The work of Drs. D. Bryson Delavan and Douglass M. Quick forms one of

the most important contributions to the subject of the treatment of

radium by cancer. (See Proceedings of the American Laryngological

Association, 1922; also Proceedings of the Tenth International

Otological Congress, Paris, 1922.)





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