Hyoid bone. X-ray of the larynx: when is it prescribed, what will the result show? Do they do X-rays of the throat?

How to prepare for the procedure?

X-rays of the trachea and larynx do not require special preparation. All the patient needs to do is make an appointment and visit the radiologist’s office at the appointed time. Before starting the procedure, you will need to remove all jewelry and clothing that contains metal elements from your neck, as they will degrade the quality of the image.

How is the examination carried out?

X-rays of the larynx are performed in two projections - lateral and direct. Direct projection can be anterior or posterior. Depending on the projection in which the picture needs to be taken, the patient will be asked to lie on his stomach or side.

The X-ray tube creates a beam of rays that is directed at the area being examined. The tissues of the human body have different densities. The softer the fabric, the better it transmits the beam. The bones prevent light from reaching the film. The resulting image will be a negative, so the lighter a certain area is, the darker it actually is. The hollow structures will appear black in the image, while the bones will appear white or light gray. If you need to see in more detail what an x-ray of the larynx will show, a procedure with contrast may be performed. To do this, a contrast agent is sprayed into the laryngeal cavity.

Decoding the results

An accurate diagnosis is established based on the results of an x-ray of the larynx and thyroid gland. Until diagnostic results are obtained, it can only be preliminary. After the photo has been taken, the patient is asked to wait outside the office. At this time, the radiologist is engaged in decoding. He evaluates the condition of all structures and compares the obtained indicators with the norm. The conclusion is also accompanied by a description of the research progress and a photograph.

Contraindications for

Since the procedure involves x-ray radiation, it is worth understanding that even with all the information it contains, it is not absolutely harmless. It is recommended to undergo it no more than once a year. In this regard, there are a number of certain situations when X-rays cannot be taken. An absolute contraindication is the patient's pregnancy. Doctors advise to make sure that there is no pregnancy if it is possible in the early stages, since otherwise the radiation can harm the fetus. However, in cases where there is a threat to the patient’s life or other research methods are impossible, the doctor can individually decide on the possibility of performing an X-ray on the pregnant woman.

Also, the procedure is usually not prescribed to patients whose age is less than 15 years. However, it may be prescribed when there is a threat to the patient's life or the perceived risk is less than the benefit of the procedure. Obese patients will not be able to find out what can be seen on X-rays of the throat and larynx, since the devices have a weight limit of 130 kilograms. In this case, you will have to think about MRI or other research methods.

Advantages and disadvantages of the procedure

The undoubted advantage is the accessibility and low cost of such research, as well as its high information content. However, some clinics use outdated equipment, the radiation dose in which is several times higher than in modern devices. We should also not forget that x-rays are associated with radiation, and therefore cannot be called absolutely harmless, and the procedure is recommended to be performed no more than once a year, in extreme cases - every six months.

The larynx is a hollow organ, therefore, during X-ray examination of the larynx there is no need to use contrasting X-ray images, however, in some cases this method may be the method of choice. For general and tomographic examination of the larynx, direct and lateral projections are used. Since, with a direct projection, the overlap of the spine on the cartilages of the larynx almost completely obscures them, with this projection, X-ray tomography is used, which removes the shadow of the spine beyond the image plane, keeping only the radiopaque elements of the larynx in focus.

In a lateral projection, against the background of the air cavities of the larynx, its cartilaginous skeleton and soft tissues are clearly visible.

Thus, in the lateral projection, the epiglottis, thyroid and cricoid cartilages are clearly visible, but the area of ​​the arytenoid cartilages is less visualized. To improve the visibility of the larynx and distance its posterior wall from the bodies of the cervical vertebrae, at the time of exposure the subject is asked to close his nose and blow strongly into it (like a Valsalva maneuver). Inflation of the epiglottis and hypopharynx leads to a more distinct manifestation of the edges of the epiglottis, the region of the arytenoid cartilages and the ventricles of the larynx.

When analyzing the results of an X-ray examination of the larynx, one should take into account the patient’s age and the degree of calcification of the cartilage of the larynx, the islands of which appear, according to I. Pane, starting from 18-20 years of age. The thyroid cartilage is most susceptible to this process.

Calcification of the cricoid cartilage begins at the superior edge of the lamina. Foci of calcification increase in different directions with age, acquiring unpredictable individual forms. Calcification of the laryngeal cartilage occurs earlier and more intensely in men.

In some cases, they resort to X-ray laryngoscopy with contrast using the method of aerosol spraying of a contrast agent.

Pharyngoscopy and laryngoscopy provide examination of the mucous membrane of the pharynx and larynx and the function of the vocal cords. Important additional data on the condition of the walls of these organs, in particular about the periglottic tissues and cartilages of the larynx, can be obtained by computed tomography.

In case of injuries, computed tomograms show cartilage fractures, swelling and hematoma in the area of ​​the vocal cords, anterior commissure of the larynx, hemorrhage in the periglottic spaces and displacement of the laryngeal skeleton. For laryngeal stenosis caused by tuberculosis or scleroma, it is possible to establish the level and degree of narrowing, the prevalence of infiltration and granulation growths. For laryngeal cancer, CT makes it possible to solve the main problem - to establish the spread of the tumor into the periglottic spaces, pyriform sinuses, and tissues located in front of the epiglottis. In addition, CT scans make it easier to detect metastases in the lymph nodes of the neck. The lymph node affected by the tumor appears as a round formation more than 2 cm in size with reduced density in the center. After radiation treatment, CT is used to assess the severity of swelling of the laryngeal tissues, and then to determine the degree of post-radiation fibrosis.

Computed tomography has practically replaced x-ray tomography and techniques with artificial contrast of the pharynx and larynx. However, in institutions where CT is not yet available, they are limited to performing radiographs of the pharynx and larynx (mainly in the lateral projection) and conventional tomograms (mainly in the frontal projection). On lateral photographs and direct tomograms, the main anatomical elements of the organ appear quite clearly: the epiglottis, epiglottal fossa (vallecules), preepiglottic space, pyriform sinuses, ventricular and true ligaments, laryngeal (Morgani) ventricles, aryepiglottic ligaments, thyroid cartilage. Starting from the age of 15-18 years, lime deposits appear in the cartilage of the larynx; they are also clearly visible on x-rays and tomograms.

The development of a tumor of the larynx leads to an increase in its affected element in photographs and tomograms; Accordingly, the adjacent air-containing cavities - laryngeal ventricles, pyriform sinuses, etc. - are deformed. Approximately the same symptoms are characteristic of tumors of the pharynx: the shadow of the tumor itself, often with a bumpy surface, and deformation of the lumen of the organ. In children, survey photographs and tomograms can clearly detect adenoid growths protruding into the nasopharynx from the side of the fornix and the posterior wall of the pharynx. The arched contours of large adenoids are clearly visible, as well as the small unevenness of the outlines of the posterior wall of the nasopharynx, caused by small growths.

In European countries, X-ray examination of the throat using the Rheti method is used.

When applying the technique, the film is located in the projection of the lower part of the pharynx. The study is carried out after anesthesia of the laryngopharyngeal region with a posteroanterior direction of the x-ray beam. For clear visualization of anatomical structures, a lateral Zemtsov image is convenient.

X-ray of the larynx - what it shows

X-ray: calcification of the laryngeal cartilage on the lateral view

X-ray of the larynx shows cartilaginous structures and soft tissues. Until recently, this organ was considered one of the worst in terms of visualization among all x-ray studies. Calcification of bones and cartilage in old age creates excellent opportunities for tracing anatomical structures.

If you supplement X-ray examinations with tomography, you can see the structure of the soft tissues of the organ. To trace the x-ray anatomy of the pharynx, it is necessary to use rays of a high degree of rigidity. The classic lateral view of the larynx shows a summary image of all anatomical structures on both sides of the neck. To level out all defects in radiographs, close-focus radiography using high-hardness rays is used.

This modification was created back in 1949, but it began to be used only recently. The main advantages of the method:

• maintaining the sharpness of the organs when the film approaches the organ tissue and blurring the shadows of the spine;
• hard beams allow you to clearly visualize the condition of soft tissues.

How is the larynx examined?

X-ray of the pharynx according to Zemtsov: calcification of the arytenoid cartilage is visible on the lateral projection

An X-ray examination of the larynx is carried out as follows:

1. The patient is placed on his side.
2. The film, wrapped in black paper, is applied to the side of the neck.
3. The focal length to it is 60 cm.
4. You should hold your breath during exposure.
5. The image should be taken in the following mode: voltage – 50 kV, current – ​​mAs.

An x-ray allows us to judge the shape, type and degree of ossification of cartilage, as well as destructive changes and the presence of foreign bodies in the larynx.

Why is pharyngeal tomography performed?

Tomography of the pharynx has not yet become widespread. Nevertheless, the technique is quite high-quality, as it allows you to clearly monitor the condition of the soft tissues.

In what projections is tomography of the throat performed?

The anterior view provides the most information because it shows structures that cannot be visualized in other views.

What diseases are visible on x-rays of the larynx?

The following throat diseases are visible on x-rays:

In all of the above diseases, narrowing of the Morgan's ventricles will be visible. Narrowing of the trachea is observed in diphtheria and whooping cough.

X-rays and tomography are excellent methods for detecting laryngeal cancer. In oncology, this study is used in combination with other diagnostic procedures:

• external examination and direct laryngoscopy;
• fibrolaryngoscopy - examination using a special diagnostic probe, which is inserted into the organ cavity;
• morphological examination after taking material from the mucous membranes allows us to identify cancerous degeneration of cells;
• X-rays are used to assess the condition of the subglottic region and the condition of the vocal cords;
• an x-ray of the lungs in combination with an image of the pharynx is performed to exclude metastases from cancer;
• Puncture of lymph nodes can also identify cancer cells.

Thus, as an independent method, the value of the technique is insignificant, but when combining the procedure with other x-ray examinations, the value of x-ray diagnostics increases significantly.

X-ray anatomy of the throat

X-ray anatomy of the throat consists of the following anatomical structures:

1. Big horns and body.
2. Root of the tongue.
3. Supraglottic valleculae.
4. Epiglottal-arytenoid ligaments.
5. Epiglottic cartilage.
6. The vestibule.
7. Morgan's ventricles.
8. Pharynx.
9. Ventricular fold.
10. Vocal cords.

The above structures are clearly visible on a lateral radiograph.

An x-ray shows different types of organ displacements in combination with changes in the epiglottis, root of the tongue and hyoid bone.

The cartilaginous structures in the picture are views of their calcification. Such changes are usually observed in people in flight.

First, the thyroid cartilage is calcified, then the cricoid and arytenoid ligaments.

An X-ray examination allows you to study the morphological state of the organ, identify narrowings and deformations along the path of the air column. X-ray examination often reveals tumor formations and foreign bodies.

Despite the fact that x-rays have not acquired sufficient diagnostic value, in some private clinics they are used to determine diseases.

How to examine the throat and larynx

A necessary condition for complete visualization of the clinical picture, assessment of the adequacy of the therapeutic effect, and the dynamics of the pathological process is early and complete diagnosis.

Ultrasound examination has become widespread in otolaryngology due to its easy-to-use, non-traumatic, and highly informative technique. Due to the high prevalence of diseases of the oropharynx, the relevant questions will be what does ultrasound of the throat and larynx show, where to undergo the examination, when is it prescribed?

Is it possible to do an ultrasound of the throat and larynx?

To identify pathology and develop treatment tactics, the doctor conducts a physical examination, collecting anamnesis, and analyzing the patient’s subjective sensations. In a number of clinical cases with an unknown genesis of the disease, ultrasound scanning of the cervical spine is prescribed.

Do they do ultrasounds of the throat and larynx? Naturally, however, this term will not be entirely correct; it is correct to say “ultrasound of the neck,” where during the study the condition of the laryngopharyngeal complex and nearby structures is assessed.

The essence of the technique is to move an ultrasonic sensor along the surface of the skin, as a result of which sound impulses are sent to tissues and organs, reflected from them, and an image of their condition, density, and parameters is projected onto the screen.

Indications for the procedure are patient complaints about pathological signs:

• pain, discomfort and sore throat;
• sensation of aspiration of a foreign substance;
• violation of the act of swallowing;
• hoarseness of voice;
• recurrent dry cough;
• mucous discharge with blood streaks, admixtures of exudate, sputum with a fetid odor;
• rapid and difficult breathing.

It is recommended to do an ultrasound to visualize additional formations in the cervical spine, enlarged and painful lymph nodes, hyperemia and swelling of tissue structures. The presence of a history of chronic inflammatory processes in the laryngeal-pharyngeal complex, previously suffered oncology of the cervical spine, abscesses, cysts require an ultrasound scan as prescribed by a doctor.

The following pathologies and conditions are mainly diagnosed using ultrasound:

• acute and chronic course of laryngitis;
• polypous formations of the larynx, adenoids;
• malignant and benign neoplasms;
• location of secondary foci of cancer growth;
• oncology of lymphatic tissue (lymphoma, lymphogranulomatosis);
• endocrine organ dysfunction;
• purulent abscess;
• anatomical changes in the trachea and esophagus.

For reference! Ultrasound is classified as a non-invasive safe research method, therefore it is allowed for children in the first days of life and women at all stages of gestation.

How to check the laryngopharyngeal apparatus

How to examine the throat and larynx? Ultrasound examination does not require preliminary preparation, therefore it is performed both routinely and in emergency clinical cases.

The technique has a built-in algorithm of actions:

1. Before checking the throat, the patient provides access to the cervical region, removes clothing and jewelry.
2. Takes a horizontal position.
3. The area being examined is treated with a special transparent gel, which prevents air from penetrating between the sensor and the skin.
4. By sliding the ultrasonic sensor on the monitor, the condition of the internal organs and tissues of more or less intense color is displayed. The total duration of the procedure varies within minutes.
5. The study data is recorded and given to the patient.

The diagnostic procedure has no contraindications, with the exception of an open wound site. Then ultrasound scanning is carried out until complete tissue regeneration.

What does an ultrasound of the cervical spine show?

• size, acoustic density of organs;
• specificity of regional lymph nodes;
• the state of the surrounding fiber;
• localization of the inflammatory process;
• additional education;
• change in gland size;
• location of foreign substances.

Particular attention is paid to hypoechoic areas, which describe a structure with lower density compared to the parameters of healthy organs. On the screen they are visualized as darkened, almost black zones (hyperechoic zones are light, white).

Their appearance is often associated with the growth of malignant tumors. Difficulties for diagnosis are caused by the asymptomatic course of the initial stage of the disease, so patients may not be aware of the development of a cancer process. Ultrasound examination of the throat and larynx does not provide reliable information about the genesis of tumor formation, but it allows it to be determined at an early stage.

For reference! Timely diagnosis of throat (larynx) oncology increases the likelihood of a favorable outcome and allows you to prolong life by 5 years or more in 75-90% of clinical cases.

Ultrasound scanning data is studied by highly specialized specialists (otolaryngologist, endocrinologist, oncologist). In a number of clinical cases, a differential approach to visualizing the pathological process with histological examination of biopsy specimens is required.

Where to do it and how much does it cost?

Diagnosis of the laryngopharyngeal complex is performed in municipal medical institutions and private clinics. The location (city), level and prestige of the clinic determine the price range. The average cost of the procedure is rubles.

Advice! It is better to give preference to medical institutions with modern equipment and qualified specialists who systematically improve their skills. When choosing a clinic, you can be guided by patient reviews and doctor’s advice.

Conclusion

Ultrasound examination of the larynx and pharynx allows not only to determine the genesis of the pathology, but also to adjust the therapeutic regimen and monitor the effectiveness of the chosen treatment tactics. The advantage of ultrasound is that it is informative, safe, non-traumatic, along with an affordable price, and the absence of contraindications to the procedure.

Directory of main ENT diseases and their treatment

All information on the site is for informational purposes only and does not claim to be absolutely accurate from a medical point of view. Treatment must be carried out by a qualified doctor. By self-medicating you can harm yourself!

Ultrasound of the throat and larynx: indications, what pathologies can be identified, technique

There are diseases the presence of which can only be determined by ultrasound. These options include tumors. An ultrasound of the throat and larynx can show various problems.

Ultrasound of the throat and larynx

Ultrasound of the throat and larynx is performed on both newborns and pregnant women. Depending on the device, the examination can be simple or advanced. The latter allows Doppler scanning.

The doctor moves an ultrasound sensor over the neck area. The impulses arrive to the tissues and glands, from which they are reflected back. The information is transmitted to the processor, where it is processed and displayed on the screen. The advantages include:

• Great diagnostic capabilities.
• No harm.
• Get results quickly.

Indications for the study

Ultrasound is prescribed for chronic or long-term diseases of the pharynx. Sometimes you cannot do without it if there is an acute sore throat, severe symptoms of intoxication without the ability to determine the cause by visual examination. Ultrasound of the pharynx and larynx is performed:

• with complaints of a foreign body;
• suspected presence of tumors or neoplasms of the tonsils;
• changes in voice timbre that persist for a long time.

During the study, several problems are solved:

1. Diseases of the larynx and throat are detected.
2. The previously made diagnosis is confirmed.
3. Selection of the appropriate treatment option.
4. Monitoring the effectiveness of the impact.

What pathologies and diseases can be identified

Ultrasound helps determine the presence of purulent abscesses, regardless of the nature of their origin. If there are oncological problems, the doctor uses a technique to determine not only the location of the formation, but also its shape and size. Sometimes injuries and accidents show no visible impairment. Ultrasound reveals them and allows you to determine the degree of deformation.

Methodology and preparation

The examination cannot be carried out if there is an open wound on the surface of the neck. This is due to the need to apply a special gel aimed at conducting ultrasonic waves.

Ultrasound does not require preparation, so it can be performed both urgently and routinely. In some cases, your doctor may suggest you stop using antibiotics for a while.

This occurs in the presence of an abscess or other acute disease. Do not drink before an ultrasound of the throat and larynx and other drugs that can blur the picture of the disease. Therefore, you should listen to the doctor’s opinion.

If the doctor studies the shape and structure of the tumor, it is recommended not to take drugs with a pronounced antitumor effect. Such drugs distort the picture or temporarily affect the parameters of the tumor, which leads to incorrect assessment.

Technique

The patient lies down on the couch. The doctor applies a small amount of gel and moves a sensor along the neck. It produces ultrasonic waves that are reflected from soft tissues and returned back. Based on the image obtained on the screen, the doctor evaluates the internal structures of the neck.

The information is entered into a special report, which is stored in two copies. One of them is issued to patients.

Technique and indications for ultrasound of the throat and thyroid gland:

What you need to know

Ultrasound of the throat and larynx is performed in both commercial and government institutions. The doctor must have certain qualifications that enable him to conduct such an examination.

If the examination reveals a pathology of the thyroid gland, the patient is referred to an endocrinologist. If there are nodes or polyps with hypoechoic signs, additional examination with a biopsy, radiography, and computed tomography is required.

In children, ultrasound of the throat and larynx is performed in the same way as in adults. The procedure does not cause any discomfort, so the children agree to it. Babies can be swaddled during the examination so that their arms and legs do not interfere with working with the sensor.

Diagnostic value of the procedure

The method has gained particular popularity in detecting cancer of the larynx and throat. During ultrasound, small lymph nodes with metastases are detected that cannot be determined by palpation. The doctor determines the most suspicious areas for further biopsy.

When using diagnostics, no radiation is released, so the study does not affect the general level of health of the patient. Thanks to the development of new equipment, this method is not inferior to the latest diagnostic methods.

Diagnosis of throat cancer

The throat is an organ of the respiratory system located between the pharynx and trachea. Throat cancer is a malignant tumor, mostly of the squamous cell type. Performs respiratory, swallowing and voice-forming functions in the body.

Features of the disease

This pathology is very common in the oncology system. Among all low-quality formations, the throat accounts for 2.5%. Among head and neck oncologies, the throat is the leader in the number of its detections.

Such a high risk of disease is important in the diagnosis of throat cancer. According to statistics, this disease is more often observed in men, so for every one sick woman there are ten men. The life expectancy of the male population with laryngeal cancer is 70-80 years, for females.

A timely and thorough examination of throat cancer provides a high guarantee of the effectiveness of treatment of this disease, therefore, identifying throat cancer is very difficult.

With a poor-quality formation of the vestibule of the larynx, or the subglottic area, cancer often proceeds for a long time and unnoticed. In comparison, the pathology of the glottis is detected at an earlier stage by signs of dysphonia, in which the cure of the disease can be complete with effective and high-quality treatment.

Throat cancer symptoms

Doctors of various specializations need to understand that with long-term hoarseness, more severe in mature men, in the absence of other symptoms, it is possible to refute the development of laryngeal cancer.

Optimal signs that require attention may include:

1. persistent cough;
2. feeling of a lump in the throat;
3. problems with swallowing;
4. pain in the hearing aid;
5. easily palpable lymph nodes.

How to identify throat cancer

Diagnosis of throat cancer begins with a questioning, visual examination or palpation of the neck. Particular attention should be paid to the patient’s complaints; based on them, one can assume the location of the tumor and the duration of its development.

All this is important for predicting the subsequent development of tumor formation and its perception of radiation. For example, the formation of the vestibular part of the larynx may be characterized by the patient as a feeling of an obstructing object in the throat and constant pain when swallowing.

When these inconveniences are accompanied by pain in the ear, a tumor can be diagnosed on the lateral wall of the larynx on one side. A change in the background of the voice signals intervention in the malignant process of the vocal tract.

Sore throat together with difficulty breathing suggests laryngeal stenosis, which means advanced disease, and if hoarseness of the voice also increases, damage to the subglottic part can be stated. When examining a patient, the doctor carefully evaluates the shape and contours of the neck, the appearance of the skin, and the mobility of the larynx.

As mentioned above, to diagnose throat (larynx) cancer, palpation provides the doctor with a significant part of the information:

• the configuration and volume of the tumor is assessed;
• its displacement relative to neighboring tissues;
• at the same time, listens to the patient’s breathing and voice, so as not to miss possible symptoms of stenosis and dysphonia. Thorough palpation of the lymph nodes is required.

With cancer, metastases can spread to all lymph nodes. To determine the final diagnosis, it is important to conduct a general clinical examination.

How to diagnose throat cancer?

1. Perform laryngoscopy, examination of the larynx with a special mirror, laryngoscope. Laryngoscopy will help detect the tumor. Also inspect the throat cavity and nasal folds. A laryngoscope is a tube with one end equipped with a video camera. In addition, laryngoscopy is used to collect tissue for biopsy;
2. A biopsy allows you to determine throat cancer and make a more accurate diagnosis. A biopsy can not only identify cancer, but also its histological type. With the help of this information, it is possible to effectively treat the disease;
3. There are some other methods for diagnosing throat cancer, imaging methods. These are such as ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET);
4. if several signs are present, direct laryngoscopy is necessary, using special devices (laryngoscope), possibly indirect laryngoscopy. Together with radiography, it is leading in identifying laryngeal cancer;
5. stroboscopy is an additional study;
6. X-ray diagnostic method is very common, since the larynx is a hollow organ with its own distinctive properties and is clearly visible on photographs without special contrast;
7. X-ray of the throat is the most accessible and effective way to detect cancer, and at the same time, it is quite informative. With its help, you can get a complete picture of the condition of the larynx and surrounding tissues. Chest X-ray provides an assessment of the extent of the neoplasm, and with the help of computed tomography, it is possible to obtain detailed information about it;
8. in examining the subglottic area, the direct fibrolaryngoscopy method is used;
9. A clinical blood test and blood tests for tumor markers are integral in the diagnosis of cancer.

Instrumental examination methods

Currently, indirect laryngoscopy, fibrolaryngoscopy, endoscopy with targeted biopsy, radiography, computed tomography of the affected area, ultrasound, and aspiration puncture of regional lymph nodes are widely used.

Indirect laryngoscopy is used to determine the location and extent of the tumor, visual assessment of the mucous membrane of the larynx and glottis, and attention is paid to the level of mobility of the vocal cords.

Fibrolaryngoscopy is considered the method of choice for trismus to diagnose throat cancer; it can be used to determine the condition of the fixed area of ​​the epiglottis and subglottic region. When using endoscopy, it is advisable to conduct a targeted biopsy to determine the degree of malignancy of the formation.

Diagnosis of throat cancer, like the examination of any other organs suspicious for cancer, is very doubtful without histological examination. If the secondary biopsy does not show oncology, and the clinic can diagnose cancer, intraoperative diagnosis is used with mandatory histological examination to confirm or refute cancer.

Detection of metastases in regional lymph nodes gives a disappointing prognosis, so it is important to be able to detect them in a timely manner. During ultrasound, nodes with existing hypoechoic areas will be suspected. When such nodes are found, it is necessary to perform a fine-needle aspiration puncture, the taken biological material is subjected to histological examination, and a repeat puncture will be required to be convincing. The accuracy of the method with a positive result is 100%.

Methods of detection and survey

• Examination of the patient;

• neck examination;
• palpation (feeling) of the cervical lymph nodes.

Before the examination, the doctor asks the patient to tilt his head forward, after which he begins to feel the cervical lymph nodes, as well as the sternocleidomastoid muscle. This helps him assess the condition of the lymph nodes and make a preliminary assumption about the presence of metastases.

Indirect laryngoscopy is an examination of the larynx, which is performed directly in the doctor’s office. The technique is quite simple, but outdated, due to the fact that a specialist cannot fully examine the larynx. In 30–35% of cases, the tumor is not detected at an early stage.

With indirect laryngoscopy, the following is determined:

• tumor location;
• tumor boundaries;
• growth pattern;
• condition of the laryngeal mucosa;
• condition (mobility) of the vocal cords and glottis.

Before the study, you should not consume (drink) liquids or eat food for some time. Otherwise, during laryngoscopy, a gag reflex may occur and vomiting may occur, and vomit may enter the respiratory tract. It should also be noted that it is recommended to remove dentures before the examination.

Research process by a specialist:

• the doctor sits the patient opposite him;
• Using a spray, local anesthesia is administered to prevent vomiting;
• the doctor asks the patient to stick out his tongue and holds it with a napkin, or presses on it with a spatula;
• with the other hand, the doctor inserts a special mirror into the patient’s mouth;
• using a second mirror and lamp, the doctor illuminates the patient’s mouth;
• During the examination, the patient is asked to say “a-a-a” - this opens the vocal cords, which facilitates the examination.

The entire period of indirect laryngoscopy examination takes no more than 5–6 minutes. The anesthetic loses its effect after about 30 minutes and during this time you should not eat or drink.

When performing direct laryngoscopy, a special flexible laryngoscope is inserted into the larynx. Direct laryngoscopy is more informative than indirect. During the study, you can clearly see all three sections of the larynx. Today, most clinics adhere to this particular examination technique.

With direct laryngoscopy, you can take a fragment of the tumor for a biopsy and remove the papilloma.

A flexible laryngoscope is a type of tube.

Before the study, the patient is prescribed medications to suppress the formation of mucus. Using a spray, a specialist administers local anesthesia and instills vasoconstrictor drops into the nose, which reduce swelling of the mucous membrane and facilitate the passage of the laryngoscope. The laryngoscope is inserted through the nose into the larynx and examined. During direct laryngoscopy, some discomfort and nausea may occur.

A biopsy is the removal of a piece of a tumor or lymph node for examination under a microscope. This study makes it possible to fairly accurately diagnose the malignant process, its type and stage.

If malignant cells are found during examination of the lymph node, then the diagnosis of laryngeal cancer is considered 100% accurate. Typically, the biopsy is taken with a special instrument during direct laryngoscopy.

Oncological lesions removed during surgery are also required to be sent to the laboratory for examination. To identify metastases, a puncture biopsy of the lymph nodes is performed. The material is obtained using a needle that is inserted into the lymph node.

An ultrasound of the neck helps the specialist evaluate the lymph nodes. Using ultrasound, the smallest lymph nodes with metastases are identified that are not detected during palpation (palpation with hands). To perform a biopsy, the doctor identifies the most suspicious lymph nodes.

Ultrasound examination of the neck for laryngeal cancer is carried out using conventional devices designed for ultrasound diagnostics. Based on the image on the monitor, the doctor assesses the size and consistency of the lymph nodes.

Chest X-ray

Chest X-ray

Chest X-ray helps identify tumor metastases in the lungs and intrathoracic lymph nodes.

X-ray photographs of the chest are taken in frontal (full face) and lateral (profile) projections.

Computed tomography (CT) and magnetic resonance imaging (MRI)

CT and MRI are modern diagnostic methods that can be used to obtain high-quality three-dimensional images or layer-by-layer sections of an organ.

Using CT and MRI, you can determine:

• position of the tumor;
• its dimensions;
• prevalence;
• germination into neighboring organs;
• metastases to lymph nodes.

These techniques provide a more accurate picture compared to radiography.

The principles of CT and MRI are similar. The patient is placed in a special apparatus, in which he must remain motionless for a certain time.

Both studies are safe, since there is no radiation exposure to the patient’s body (MRI), or it is minimal (CT). During an MRI, the patient should not have any metal objects with him (the presence of a pacemaker and other metal implants is a contraindication for MRI).

First of all, this study is intended to assess the condition of the heart in laryngeal cancer, which is included in the mandatory diagnostic program.

The patient is placed on a couch, and special electrodes are placed on the arms, legs and chest. The device records the electrical impulses of the heart in the form of an electrocardiographic curve, which can be displayed on tape or, in the presence of modern devices, on a computer monitor.

Endoscopic examination of the bronchi is carried out using a special flexible instrument - an endoscope. This study is carried out only when indicated. For example, if changes are detected during a chest x-ray.

What needs to be done before preparing the patient for the study:

1. as prescribed by the doctor, some time before the study, the patient is administered medications;
2. it is necessary to remove dentures and piercings;
3. the patient is seated or laid on the couch;
4. local anesthesia is administered: the mucous membranes of the mouth and nose are irrigated with an aerosol of anesthetic;
5. the bronchoscope is inserted into the nose (sometimes into the mouth), advanced into the larynx, then into the trachea and bronchi;
6. examine the bronchial mucosa. If necessary, a photo is taken and a biopsy is taken.

Stages of disease development, course and prognosis

Depending on the location and spread of the malignant lesion, the stages of disease development are distinguished:

Stage 0 - diagnosing the disease at stage zero happens extremely rarely, since there are almost no symptoms during this period. And yet, if the diagnosis of cancer is made at this stage, then the success rate of getting rid of it is quite high, while the survival rate of patients over the next five years is 100%;

Stage 1 - the tumor extends beyond the boundaries of the laryngeal mucosa. But it does not spread to neighboring tissues and organs. With first stage laryngeal cancer, vibration of the vocal folds and generation of sounds are observed. A successfully chosen treatment gives patients a chance to live another 5 years, the number of such people corresponds to 80%;

Stage 2 - cancer spreads to one of the areas of the larynx and completely affects it. Does not leave the boundaries of its occupied area. The vocal cords remain mobile. Metastases at this stage have not yet formed, or are isolated in the lymph nodes. With an adequate choice of treatment, second-stage laryngeal cancer allows the patient to live another five years in 70% of cases;

Stage 3 - the malignant formation has a large volume and is already damaging nearby tissues and neighboring organs. The tumor gives single or multiple metastases. The vocal cords lose their mobility. The person's voice becomes hoarse or absent altogether. With optimal treatment, the five-year survival rate for patients with cancer at this stage is 60%;

Stage 4 - the tumor reaches an impressive size and affects all neighboring tissues. It acquires such volumes that it can fill almost the entire larynx. Stage 4 laryngeal cancer most often cannot be treated. The development of cancer has reached its limit. All neighboring tissues have already been affected, the tumor has deepened too much. Cancer affects some organs, such as the thyroid gland and esophagus. In this interval, many regional and distant metastases are detected. Here, only supportive treatment and pain relief will help alleviate the patient’s suffering. The survival rate for such patients over the next five years is predicted to be only 25%.

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