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Последний просмотренный: 28 Jan 2026
Last updated: 15 Apr 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • 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
Полная информация

Другие диагностические факторы

  • 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
Полная информация

Факторы риска

  • 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
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • neck CT with contrast
  • chest CT with or without contrast
  • MRI with and without contrast
  • fine needle aspiration of neck mass
  • flexible fiberoptic laryngoscopy
Полная информация

Исследования, проведение которых нужно рассмотреть

  • rigid videostroboscopy
  • rigid direct laryngoscopy
  • immunohistochemistry testing
  • laryngeal biopsy
  • whole-body PET/CT scan
  • fluorescence endoscopy
Полная информация

Алгоритм лечения

Острый

glottic or supraglottic

subglottic

ПРОДОЛЖЕНИЕ

treatment not effective/appropriate

Составители

Авторы

Matthew Pierce, MD

Otolaryngologist

Otolaryngology, Head and Neck Division

MedStar Washington Hospital Center

Georgetown University

Washington

DC

Раскрытие информации

MP declares that he has no competing interests.

Выражение благодарностей

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.

Раскрытие информации

SVL, HD, EK, and AC declare that they have no competing interests.

Рецензенты

Alfio Ferlito, MD, DLO, DPath, FRCSEd

Director

Department of Surgical Sciences

Professor and Chairman

ENT Clinic

University of Udine

Udine

Italy

Раскрытие информации

AF declares that he has no competing interests.

Steven J. Charous, MD, FACS

Assistant Professor

Department of Otolaryngology

Rush University Medical Center

Chicago

IL

Раскрытие информации

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.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: head and neck cancers [internet publication].Полный текст

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.Полный текст  Аннотация

American College of Radiology. ACR Appropriateness Criteria: retreatment of recurrent head and neck cancer after prior definitive radiation. 2014 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Рекомендации

    • 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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