Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- age >40 years
- hoarseness
- dysphagia
- odynophagia (painful swallowing)
- cervical lymphadenopathy
- supraglottic or glottic mass
- lesional erythroplasia, ulceration, necrosis, or bleeding
- signs of airway obstruction
- hemodynamic instability
Otros factores de diagnóstico
- sore throat
- otalgia
- dyspnea
- middle ear effusion
- stridor
- weight loss or cachexia
- general distress
- oral and pharyngeal masses or leukoplakia
- loss of laryngeal crepitus
- parotid and thyroid growths
- diminished breath sounds
Factores de riesgo
- tobacco use
- alcohol use >8 units/day
- history of radiation therapy
- black ethnicity
- male sex
- vocal fold dysplasia
- GERD
- achlorhydria
- family history of laryngeal cancer
- Agent Orange exposure
- human papillomavirus (HPV) infection
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- neck CT with contrast
- chest CT with or without contrast
- MRI with and without contrast
- fine needle aspiration of neck mass
- flexible fiberoptic laryngoscopy
Pruebas diagnósticas que deben considerarse
- rigid videostroboscopy
- rigid direct laryngoscopy
- immunohistochemistry testing
- laryngeal biopsy
- whole-body PET/CT scan
- fluorescence endoscopy
Algoritmo de tratamiento
glottic or supraglottic
subglottic
treatment not effective/appropriate
Colaboradores
Autores
Matthew Pierce, MD
Otolaryngologist
Otolaryngology, Head and Neck Division
MedStar Washington Hospital Center
Georgetown University
Washington
DC
Divulgaciones
MP declares that he has no competing interests.
Agradecimientos
Dr Matthew Pierce would like to gratefully acknowledge Dr Scott V. Larson, Dr Hari Deshpande, Dr Elina Kari, Dr Amy Chen, and the late Dr Clarence Sasaki, previous contributors to this topic.
Divulgaciones
SVL, HD, EK, and AC declare that they have no competing interests.
Revisores por pares
Alfio Ferlito, MD, DLO, DPath, FRCSEd
Director
Department of Surgical Sciences
Professor and Chairman
ENT Clinic
University of Udine
Udine
Italy
Divulgaciones
AF declares that he has no competing interests.
Steven J. Charous, MD, FACS
Assistant Professor
Department of Otolaryngology
Rush University Medical Center
Chicago
IL
Divulgaciones
SJC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: head and neck cancers [internet publication].Texto completo
Forastiere AA, Ismaila N, Lewin JS, et al. Use of larynx-preservation strategies in the treatment of laryngeal cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2018 Apr 10;36(11):1143-69.Texto completo Resumen
American College of Radiology. ACR Appropriateness Criteria: retreatment of recurrent head and neck cancer after prior definitive radiation. 2014 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
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Más DiferencialesGuías de práctica clínica
- NCCN clinical practice guidelines in oncology: head and neck cancers
- Expert consensus statement: management of dysphagia in head and neck cancer patients
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