University of Rijeka. Faculty of Medicine. Department of Otorhinolaryngology.
Abstract
Skvamozni karcinom grkljana najčešći je maligni tumor grkljana. Brojni čimbenici utječu na pojavu bolesti ali najistaknutiji su pušenje i konzumiranje alkohola. U većini slučajeva javlja se u starijih muškaraca koji kroz dugi niz godina redovito puše i konzumiraju alkohol. Klinička slika veoma zavisi o primarnom sijelu tumora. U nekim regijama tumor se detektira rano zbog ranog javljanja simptoma dok u drugih regija, prvi znak može biti pojava čvorića na vratu. Kao i u drugih tumora glave i vrata, mjesto pojave limfogenih metastaza može se predvidjeti zbog poznatog puta širenja pojedinih regija. To se iskorištava radi preventivnog (elektivnog) ali i kurativnog liječenja. Uklanjanje limfnih čvorova vrata još je od davnina poznata operacija pod nazivom disekcija vrata. U prošlosti je to bila vrlo radikalna operacija s uklanjanjem svih limfnih regija vrata i nekih nelimfatičkih struktura. S vremenom, sakupljanjem različitih iskustva i znanja, te operacije postaju sve poštednije. Shvaćeno je da je moguće dobiti isti rezultat ali uz puno manje funkcionalnih i estetskih deformiteta. Tako se od uklanjanja svih limfnih regija vrata i nekih nelimfatičkih struktura (radikalna disekcija vrata) došlo do uklanjanja samo pojedinih regija i očuvanja nelimfatičkih struktura (selektivna disekcija vrata). U današnje vrijeme traže se nove metode kako bi se postigao optimalan opseg zahvata i pronašla adekvatna terapija.Squamous cell carcinoma of the larynx is the most often malignant tumor of the larynx. Numerous factors affect the occurrence of this disease but the most important ones are smoking and drinking alcohol. In most cases, it occurs in older men who smoke and drink alcohol on a daily basis for a long time. Clinical finding depends on the localization of the primary tumor. In some regions, the tumor is detected early due to early symptoms, while in the other regions, the first sign may be appearance of the nodule on the neck. As in the other head and neck tumors, the site of lymphatic metastases can be predicted due to the known route of spreading of certain regions. This is used for preventive (elective) but also for a curative treatment. Removal of the lymph nodes of the neck has long been known as an operation called neck dissection. In the past, it was a very radical operation with the removal of all lymphatic regions of the neck and some nonlymphatic structures. Over time, by gathering different experiences and knowledges, these operations become more and more spared. It is understood that it is possible to obtain the same result but with much less functional and aesthetic deformities. With time, radical neck dissection, in which all lymph node regions and some nonlymphatic structures were removed, was replaced with selective neck dissection, in which only certain regions were removed and nonlymphatic structures were preserved. Nowadays, new methods are being sought in order to achieve the optimal extent of the procedure and find adequate therapy
