喉癌：尼日利亚伊莱-伊费的经验

Amusa Y B, Badmus A, Olabanji J K, Oyebamiji E O

Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.

Niger J Clin Pract. 2011 Jan-Mar;14(1):74-8. doi: 10.4103/1119-3077.79268.

OBJECTIVES

This study aimed to determine the prevalent age, pattern of presentation, histopathology type, and outcome of management of laryngeal carcinoma in our environment.

DESIGN AND SETTING

This was a 10-year retrospective study carried out at a teaching hospital.

MATERIALS AND METHODS

Records of patients managed for laryngeal carcinoma from January 1994 to December 2004 were reviewed. Only 13 cases with tissue diagnosis were included in this review. The age, sex, occupation, presentation, use of cigarette and alcohol, investigations, histology, outcome of management, and duration of follow-up were extracted and analyzed.

RESULTS

The patients had a mean age of 69.9 years (range 38-88 years) and a male-to-female ratio of 12:1. Histopathology was squamous cell carcinoma in all. Symptoms included hoarseness in voice and breathlessness in all, cough in 7 (53.8%), weight loss in 7 (53.8%), and otalgia in 6 (46.2%). Two patients indulged in alcohol and two were also regular cigarette smokers. All the patients presented with stage IV disease and in respiratory distress necessitating emergency tracheostomy. Seven (53.8%) patients had total laryngectomy plus postoperative radiotherapy while 2 (15.4%) had pharyngolaryngectomy, thyroidectomy, radical neck dissection plus postoperative radiotherapy and thyroxine supplement. Surgical complications included pharyngocutaneous fistula in 2 (15.4%) patients, pharyngeal stenosis, stomal stenosis, and hypocalcemia with hypothyroidism in 1 patient each. The fistulae were managed conservatively and prognosis was good despite late presentation.

CONCLUSION

Laryngeal carcinoma mainly occurs in males. Presentation is late with hoarseness in voice and breathlessness in our community. Soft-tissue neck x-ray is a useful diagnostic tool. Scarce radiotherapy centers, ignorance, local taboo, poverty, and poor recognition by primary healthcare providers have a negative impact on its management. Laryngeal carcinoma should be excluded when managing elderly patients for bronchial asthma.

目的

本研究旨在确定我院环境中喉癌的发病年龄、临床表现模式、组织病理学类型及治疗结果。

设计与背景

这是一项在一家教学医院开展的为期10年的回顾性研究。

材料与方法

回顾1994年1月至2004年12月期间喉癌患者的病历记录。本回顾仅纳入13例经组织学诊断的病例。提取并分析患者的年龄、性别、职业、临床表现、烟酒使用情况、检查、组织学、治疗结果及随访时间。

结果

患者的平均年龄为69.9岁（范围38 - 88岁），男女比例为12:1。所有患者的组织病理学均为鳞状细胞癌。症状包括全部患者均有声音嘶哑和呼吸急促，7例（53.8%）有咳嗽，7例（53.8%）有体重减轻，6例（46.2%）有耳痛。2例患者饮酒，2例也是经常吸烟者。所有患者均表现为IV期疾病且处于呼吸窘迫状态，需要紧急气管切开术。7例（53.8%）患者接受了全喉切除术加术后放疗，2例（15.4%）患者接受了咽喉切除术、甲状腺切除术、根治性颈清扫术加术后放疗及甲状腺素补充治疗。手术并发症包括2例（15.4%）患者出现咽皮肤瘘，1例患者出现咽狭窄、造口狭窄及低钙血症合并甲状腺功能减退。瘘管采用保守治疗，尽管就诊较晚，但预后良好。