What is the larynx?
The larynx is an organ at the front of your neck. It is also called the voice box. It is about 2 inches long and 2 inches wide. It is above the windpipe (trachea). Below and behind the larynx is the esophagus.
The larynx has two bands of muscle that form the vocal cords. The cartilage at the front of the larynx is sometimes called the Adam's apple.
The larynx has three main parts: -
- The top part of the larynx is the supraglottis.
- The glottis is in the middle. Your vocal cords are in the glottis.
- The subglottis is at the bottom. The subglottis connects to the windpipe.
The larynx plays a role in breathing, swallowing, and talking. The larynx acts like a valve over the windpipe. The valve opens and closes to allow breathing, swallowing, and speaking: -
- Breathing: - When you breathe, the vocal cords relax and open. When you hold your breath, the vocal cords shut tightly.
- Swallowing: - The larynx protects the windpipe. When you swallow, a flap called the epiglottis covers the opening of your larynx to keep food out of your lungs. The food passes through the esophagus on its way from your mouth to your stomach.
- Talking: - The larynx produces the sound of your voice. When you talk, your vocal cords tighten and move closer together. Air from your lungs is forced between them and makes them vibrate. This makes the sound of your voice. Your tongue, lips, and teeth form this sound into words.
Symptoms of Laryngeal CancerThe symptoms of cancer of the larynx depend mainly on the size of the tumor and where it is in the larynx.
Symptoms may include the following: -
- Hoarseness or other voice changes
- A lump or swelling in the neck
- Pain in the neck
- A sore throat that doesn't go away within 1 to 2 weeks, even with antibiotics
- Feeling like something is stuck in your throat
- Difficulty swallowing
- A cough that does not go away
- Coughing up blood
- Problems breathing
- Bad breath
- An earache
- Unexplained weight loss
Causes of laryngeal cancerThere is no single cause of laryngeal cancer but some factors increase the risk of developing it. Most people diagnosed with laryngeal cancer are over the age of 50. Men are more likely to be diagnosed with this disease than women.
Other factors that appear to increase the risk of laryngeal cancer are: -
- smoking, especially if you also drink a lot of alcohol
- drinking a lot of alcohol, especially if you also smoke
- exposure to sulphuric acid mist
Signs and symptoms of laryngeal cancerMost laryngeal cancers start on or near the vocal cords. Laryngeal cancer is often diagnosed in its early stages because even a very small tumour can stop the vocal cords from vibrating properly and cause your voice to change. Sometimes, the tumour may start in a part of the larynx that is not close to the vocal cords. Then the first sign may be difficulty swallowing or a lump in the throat or neck.
Possible symptoms of laryngeal cancer include: -
- changes to the voice, such as hoarseness
- difficulty or pain when swallowing
- a sore throat or feeling that something is stuck in the throat
- a cough that doesn’t go away
- an earache
- difficulty breathing or noisy breathing
DiagnosisIf you have symptoms of cancer of the larynx, the doctor may do some or all of the following exams: -
- Physical exam. The doctor will feel your neck and check your thyroid, larynx, and lymph nodes for abnormal lumps or swelling. To see your throat, the doctor may press down on your tongue.
- Indirect laryngoscopy. The doctor looks down your throat using a small, long-handled mirror to check for abnormal areas and to see if your vocal cords move as they should. This test does not hurt. The doctor may spray a local anesthesia in your throat to keep you from gagging. This exam is done in the doctor's office.
- Direct laryngoscopy. The doctor inserts a thin, lighted tube called a laryngoscope through your nose or mouth. As the tube goes down your throat, the doctor can look at areas that cannot be seen with a mirror. A local anesthetic eases discomfort and prevents gagging. You may also receive a mild sedative to help you relax. Sometimes the doctor uses general anesthesia to put a person to sleep. This exam may be done in a doctor's office, an outpatient clinic, or a hospital.
- CT scan. An x-ray machine linked to a computer takes a series of detailed pictures of the neck area. You may receive an injection of a special dye so your larynx shows up clearly in the pictures. From the CT scan, the doctor may see tumors in your larynx or elsewhere in your neck.
- Biopsy. If an exam shows an abnormal area, the doctor may remove a small sample of tissue. Removing tissue to look for cancer cells is called a biopsy. For a biopsy, you receive local or general anesthesia, and the doctor removes tissue samples through a laryngoscope. A pathologist then looks at the tissue under a microscope to check for cancer cells. A biopsy is the only sure way to know if a tumor is cancerous.
Treatment for laryngeal cancerRadiation therapy
External beam radiation therapy is the most common treatment for laryngeal cancer. A machine is used to carefully aim a beam of radiation at the tumour. The radiation damages the cells in the path of the beam – normal cells as well as cancer cells.
Small tumours may be cured by treating them with radiation only. For larger tumours, external radiation is often used together with chemotherapy.
You may have a mask made especially for you before radiation therapy. This custom-made mask is worn for the treatment planning and for all radiation treatments. The mask helps make sure you’re in the exact same position for every treatment and helps keep your head and neck from moving during treatment.
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