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Câncer laríngeo

Last reviewed: 13 Feb 2025
Last updated: 16 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • idade >40 anos
  • rouquidão
  • disfagia
  • odinofagia (deglutição dolorosa)
  • linfadenopatia cervical
  • massa supraglótica ou glótica
  • eritroplasia lesional, ulceração, necrose ou sangramento
  • sinais de obstrução das vias aéreas
  • instabilidade hemodinâmica
Full details

Other diagnostic factors

  • faringite
  • otalgia
  • efusão no ouvido médio
  • estridor
  • perda de peso ou caquexia
  • sofrimento geral
  • massas orofaríngeas ou leucoplasia
  • perda de crepitação laríngea
  • crescimentos na parótida e tireoide
  • murmúrio vesicular diminuído
Full details

Risk factors

  • tabagismo
  • uso de álcool >8 unidades/dia
  • história de radioterapia
  • etnia negra
  • sexo masculino
  • displasia das pregas vocais
  • Doença do refluxo gastroesofágico (DRGE)
  • acloridria
  • história familiar de câncer laríngeo
  • exposição ao Agente Laranja
  • infecção por papilomavírus humano (HPV)
Full details

Diagnostic tests

1st tests to order

  • tomografia computadorizada (TC) de pescoço com contraste
  • TC de tórax com ou sem contraste
  • RNM com e sem contraste
  • aspiração por agulha fina (AAF) da massa cervical
  • laringoscopia com fibra óptica flexível
Full details

Tests to consider

  • videoestroboscopia rígida
  • laringoscopia direta e rígida
  • teste de imuno-histoquímica
  • biópsia da laringe
  • PET/TC do corpo inteiro
  • endoscopia de fluorescência
Full details

Treatment algorithm

ACUTE

glótico ou supraglótico

subglótico

ONGOING

tratamento ineficaz/inadequado

Contributors

Authors

Matthew Pierce, MD

Otolaryngologist

Otolaryngology, Head and Neck Division

MedStar Washington Hospital Center

Georgetown University

Washington

DC

Disclosures

MP declares that he has no competing interests.

Acknowledgements

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.

Disclosures

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

Peer reviewers

Alfio Ferlito, MD, DLO, DPath, FRCSEd

Director

Department of Surgical Sciences

Professor and Chairman

ENT Clinic

University of Udine

Udine

Italy

Disclosures

AF declares that he has no competing interests.

Steven J. Charous, MD, FACS

Assistant Professor

Department of Otolaryngology

Rush University Medical Center

Chicago

IL

Disclosures

SJC declares that he has no competing interests.

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