FEDERAL EDUCATION AGENCY

BALTIC FEDERAL UNIVERSITY named after. I. KANTA

FACULTY OF MEDICINE

Report on the subject “ENT diseases” on the topic:

Oncology of ENT organs

Performed:

Third year student LD-1 SPO

Vaganova Olga

2 subgroup

Checked:

Demchenko E.V.

Kaliningrad

2012 Tumors of the respiratory tract

Tumors of the upper respiratory tract - the nose and its paranasal sinuses, pharynx and larynx, as well as the ear - are relatively common. They make up about 4-5% of all tumor sites in humans. Among the upper organs respiratory tract benign and malignant tumors are most often localized in the larynx, the second most common place is the nose and its paranasal sinuses, then the pharynx; Ear diseases are relatively rare. Malignant tumors, especially of the larynx, occur more often in men than in women between the ages of 40 and 70 years. However, they also occur in children.

In accordance with the International Classification, tumors are divided according to histological structure and clinical course into benign and malignant; they can come from epithelial, connective, muscle, nervous and pigment tissues.

The histological structure of the tumor characterizes the degree and characteristics of the degeneration of cells of the affected tissue, their germination (infiltration) into the surrounding tissue. The clinical course reveals the characteristics of tumor growth, its ability to metastasize and recur after treatment, etc. The histological picture usually corresponds to the clinical one, but sometimes a tumor that is benign in its histological structure clinically grows in a malignant form and, conversely, a histologically malignant tumor has the clinical features of a benign one.

Benign tumors

Tumors of the nose. These include papillomas, fibromas, angiomas and angiofibromas, chondromas, osteomas, neuromas, nevi, warts. Some also include mucous polyps here, but these formations do not have a tumor structure and represent inflammatory and allergic hyperplasia of the mucous membrane. Typical signs are persistent difficulty breathing through the half of the nose in which the tumor is located, hyposmia or anosmia; minor bleeding is possible. IN late stages- deformation of the facial skeleton, headache, displacement of the eyeballs, visual disturbances. Diagnosis: nasal endoscopy, probing of the tumor, palpation, radiography, histological examination of a piece of the tumor. Papillomas are usually localized in the vestibule of the nose, grow relatively slowly, and often recur after removal. Removal must be radical. In order to prevent scarring after excision of papilloma, cryotherapy is applied to the wound surface. Vascular tumors form on the nasal septum, the bowl in its cartilaginous part, the inferior nasal turbinates, and the nasal cavity. They grow slowly, usually bleed periodically, sometimes very heavily, gradually increase in size and can fill the nasal cavity, grow into the ethmoid labyrinth, orbit and maxillary sinus. Treatment is surgical. Before removing the tumor, the external carotid arteries are often ligated on both sides.

A bleeding polyp resembles an angiofibroma in structure, is localized in the cartilaginous part of the nasal septum and usually has a wide stalk. More common during pregnancy and lactation. Persistent symptom- frequent bleeding, usually not in small portions. Removal must be radical. After removal, galvanocaustics of the wound edges is performed. Nasal fibroma is rare and is usually localized in the vestibule of the nose, nasopharynx and in the area of ​​the external nose. Treatment is surgical. Osteomas of the nose and paranasal sinuses usually appear at the age of 15-25 years, grow slowly, and are most often localized in the walls of the frontal sinuses and ethmoid bone. Long-term observation is carried out. Sometimes small osteomas, especially on the cerebral wall of the frontal sinus, are the cause of persistent headaches. After excluding other causes of headache, removal of such osteoma is indicated. In some cases, they deform the facial skeleton and cause brain disorders. Treatment. Surgical only. Osteomas of medium and large sizes even in the absence severe symptoms must be completely removed.

Tumors of the pharynx. These include: fibroma, papilloma, hairy polyp, angioma, neuroma, neurofibroma, lipoma, cysts and retropharyngeal goiter.

The most common types of papillomas and fibromas are pedunculated.

Papillomas are usually located on the soft palate and palatine arches, are small in size and, as a rule, do not bother patients much. In some cases, papillomas originate from the nasopharynx, the lateral walls of the pharynx, and the lingual surface of the epiglottis. Treatment consists of removing single papillomas followed by galvanocaustics. Relapses of the disease with single papillomas are rare. With papillomatosis, relapses can occur repeatedly. Given the possibility of degeneration into cancer, timely radical treatment is necessary.

Fibroma occurs, as a rule, in young men aged 10-20 years, which is why it is called juvenile. After 20-25 years, juvenile fibroma undergoes a reverse development. In the early stage of development of nasopharyngeal fibroma, its manifestations are moderately pronounced - slight difficulty in nasal breathing, sore throat, minor catarrhal phenomena. Subsequently, breathing stops completely through one half of the nose and becomes difficult through the other, a nasal sound appears, the voice changes, the most severe symptom is periodically occurring heavy spontaneous bleeding. The fibroid usually fills the nasopharynx and may hang into the middle part of the pharynx.

Angioma is a relatively common benign neoplasm of the pharynx and can originate from various parts of the pharynx. Small angiomas long time may not increase, do not bother the patient and are detected only during examination. Medium and large angiomas cause a sensation of a foreign body in the nasopharynx, make nasal breathing difficult, and can bleed. There are hemangiomas and lymphangiomas.

Treatment is surgical; electrocoagulation is also used. A hairy polyp is a congenital tumor, has a long stalk, and is covered with skin with delicate hairs.

The polyp makes breathing and sucking difficult. Treatment is surgical. Relapses do not occur.

Pharyngeal cysts are not classified as true tumors. They are localized in various parts of the pharynx, most often in the tonsils. The sizes are often small, so they often do not cause any particular concern, but sometimes there is a sensation of a foreign body in the throat; V early age Cysts on the root of the tongue can cause suffocation.

Neuromas, mixed endothelioma tumors and other pharyngeal tumors are rare. They have slow, non-infiltrating growth and in rare cases can become malignant.

Tumors of the larynx. These include fibromas, papillomas and angiomas.

Fibroma (fibrous polyp) usually occurs at the free edge of the vocal fold on the border between the anterior and middle thirds, grows very slowly, and often does not reach large sizes. The main symptoms of the disease are hoarseness and possibly cough. The voice may change if the fibroma has a long stalk and is easily displaced. Treatment is surgical; relapses are possible if a piece of tumor is left behind.

Papillomas are single or papillary growths that look like cauliflower. Most often they are located on the vocal folds. Most often, papillomas occur between the ages of 1.5 and 5 years. By the beginning of puberty they often disappear. The main symptoms of the disease are hoarseness, reaching aphonia, and gradual difficulty breathing, which can turn into suffocation as the tumor enlarges. Treatment is surgical. Relapses of the disease after treatment are common, but the tendency to relapse varies from person to person: in some cases, papillomas have to be removed several times a year, in others – after several years.

Cysts are not common in the larynx. They are usually localized on the laryngeal surface of the epiglottis. More often, cysts develop as a result of blockage of the mucous glands; they grow slowly and do not reach large sizes. Small cysts usually do not cause any symptoms and do not require treatment.

Laryngeal angiomas originate from dilated blood vessels (hemangiomas, lymphangiomas). They can be localized on the vocal folds, sometimes on the ventricular or aryepiglottic folds. They grow slowly and are usually small in size. Sometimes the tumor reaches a large size and hangs into the lumen of the larynx, impairing breathing. Small angiomas are of concern only if they are localized on the vocal fold - this causes hoarseness. Medium and large angiomas also disrupt other functions of the larynx, so they must be removed.

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GBOU VPO TSMU

Ministry of Health of the Russian Federation

Department of Ophthalmology and Otorhinolaryngology

Abstract on the topic

"Benign neoplasms of the ENT organs"

Vladivostok, 2015

Benign tumors of the nose and paranasal sinuses

Benign tumors of the nose and paranasal sinuses include papillomas, fibromas, angiomas, chondromas and osteomas, neuromas, nevi (pigmented tumors), warts.

Papilloma, a relatively rare tumor, is equally often detected in men and women aged 50 years, but it also occurs at an earlier age. There are mushroom-shaped, inverted and transitional cell papillomas. The mushroom-shaped form is localized in the vestibule of the nose (nasal septum, floor, inner surface of the wings of the nose) and in appearance resembles cauliflower. Inverted and transitional cell papillomas originate from the mucous membrane of the deep parts of the nasal cavity, most often located on the lateral wall. The surface of such a tumor is smooth, and upon examination the neoplasm can be mistaken for an ordinary polyp. The last two types of papillomas are capable of destroying soft tissue and bone walls, penetrating into the paranasal sinuses and even beyond them. Inverted and transitional cell papillomas are prone to malignancy, which is observed in 4-5% of patients. There is an opinion that the malignancy of benign tumors, including papillomas, is promoted by irradiation

Treatment is surgical. After removal of the fungiform papilloma, cryotherapy or electrocoagulation of the original tumor site is performed. Inverted and transitional cell papillomas are removed using the Denker approach and, if necessary, the Moore approach, and one should strive to complete removal tumors.

Vascular tumors of the nasal cavity (capillary and cavernous hemangiomas, lymphangiomas) are relatively rare and develop on the nasal septum, inferior turbinates, and in the area of ​​the vault of the nasal cavity. They grow slowly, periodically bleed, gradually increase in size and can fill the nasal cavity, grow into the ethmoid labyrinth, orbit and maxillary sinus; more often they have the appearance of a round, lumpy cyanotic tumor. It should be borne in mind that hemangiomas located on the lateral wall of the nasal cavity have an increased tendency to malignancy. Surgical treatment involves removing the tumor along with the underlying mucosa.

Osteoma is a benign tumor arising from bone tissue and characterized by slow growth. Most often located in the frontal sinuses and ethmoid bone, less often in the maxillary sinuses.

Small osteomas often go unnoticed and are discovered by chance on an x-ray of the paranasal sinuses. In the absence of functional, cosmetic and other disorders, there is no basis for immediate surgical treatment of osteoma.

In this case, long-term observation is carried out; noticeable growth of osteoma is an indication for its removal. It should be noted that sometimes small osteomas, especially on the cerebral wall of the frontal sinus, are the cause of persistent headaches. After excluding other causes of such headache, removal of such osteoma is indicated. Sometimes osteomas reach large sizes, can spread into the cranial cavity, orbit, deform the facial skeleton and cause brain disorders, headaches, decreased vision, impaired nasal breathing and sense of smell. The treatment is surgical, a radical operation is performed on the frontal sinus with removal of the tumor. Osteomas of medium and large sizes, even in the absence of severe symptoms, must be removed.

Benign tumors of the pharynx

The most common are papilloma, juvenile angiofibroma and angioma.

Papillomas are usually soft, often located on the palate and palatine arches, sometimes on the posterior or lateral walls of the pharynx and the lingual surface of the epiglottis and usually do not bother the patient much. Have characteristic appearance: grayish-pink in color, broad-based or pedunculated.

Diagnosis based on the appearance of the tumor and histological examination data does not present any difficulties.

Treatment consists of removing single papillomas followed by galvanocaustics; Cryotherapy is possible on areas of papillomatous degeneration. Sometimes papillomas are removed using an ultrasonic disintegrator or surgical laser. If papillomas recur, repeated removal is indicated, after which 30% prospidin ointment is applied to the wound surface daily for 10-15 days.

Adolescent (juvenile) angiofibroma is a tumor of the nasopharynx, emanating from its dome or the area of ​​the pterygopalatine fossa, which has a benign histological structure, but according to its clinical course (destructive growth, severe bleeding, frequent relapses after surgery, germination into the paranasal sinuses and even into the cavity skull) manifesting itself as a malignant formation.

Angiofibroma occurs most often in young men aged 10-18 years. that is why it is called youthful; after 20 years it usually undergoes reverse development. It is believed that nasopharyngeal fibroma arises from abnormally detached remnants of mesenchymal tissue in the nasopharynx during the embryonic period. The fibroma stroma consists of variously located connective tissue fibers and a very large number of blood vessels. The source of tumor growth may be the body sphenoid bone, pharyngeal-basic fascia and posterior cells of the ethmoid bone are a sphenoethmoidal type of fibroma. From here, the tumor can grow into the ethmoid labyrinth, sphenoid sinus, nasal cavity, orbit and maxillary sinus. If the tumor grows from the area of ​​the nasopharynx, then this is a basal type of fibroma; it can grow towards the oropharynx. When a fibroid starts from the area pterygoid process of the sphenoid bone, it belongs to the pterygoomaxillary type of tumor and can grow into the retromaxillary space, pterygopalatine fossa, inside the skull, orbit and nasal cavity. In accordance with the direction of fibroma growth, asymmetry of the type occurs, the surrounding bone and soft tissues are compressed and deformed, which can lead to displacement eyeball, impaired blood supply various departments brain, compression of nerve formations.

Clinical picture depends on the stage of propagation of the process. In practical work, the following classification of juvenile angiofibromas is convenient (Pogosov V.S. et al., 1987):

Stage I tumor occupies the nasopharynx and (or) nasal cavity, bone destruction absent;

Stage II tumor corresponds to stage I, spreads into the pterygoid fossa, paranasal sinuses, bone destruction is possible;

Stage III, the tumor spreads to the orbit and brain;

Stage IV tumor corresponds to stage III, but spreads to the cavernous sinus, optic chiasm and pituitary fossa.

At the beginning of the disease, the patient notes a slight difficulty in nasal breathing, a sore throat, and minor catarrhal symptoms. Subsequently, breathing through one half of the nose stops completely and becomes difficult through the other, sense of smell is impaired, nasal sounds appear, the voice changes, and the face takes on the appearance of an adenoid. The most severe and common symptom is recurrent nosebleeds, causing anemia and weakening of the body. The tumor may be accompanied purulent sinusitis and otitis media, which makes timely diagnosis difficult.

With anterior and posterior rhinoscopy, you can see a round, smooth or lumpy tumor of a bright red color, dense when examined digitally or when palpated with a probe. The fibroid usually fills the nasopharynx and may hang into the middle part of the pharynx. On palpation, the tumor may bleed profusely; its base is located in the upper part of the nasopharynx.

Diagnostics. It is carried out on the basis of the noted symptoms, taking into account data from endoscopic (including using a fiber endoscope), X-ray, and in some cases angiographic examination. When determining the spread of the tumor process, the decisive role belongs to computed tomography and nuclear magnetic resonance imaging. Juvenile angiofibroma should be differentiated from adenoids, choanal polyp, papilloma, sarcoma, cancerous tumor, adenoma. The final diagnosis is established on the basis of a biopsy, which presents certain difficulties and should only be performed in an ENT hospital. where there are all conditions to stop bleeding.

Treatment is only surgical and, if possible, radical, as relapses are possible. Considering fast growth tumors, surgery should be performed as early as possible. The intervention is performed under anesthesia; surgical approaches are endoral, endonasal and transmaxillary. Modifications may be used radical surgery according to Moore, Denker. During surgery, there is usually severe bleeding, which requires massive blood transfusions. Before tumor removal, external ligation is often performed. carotid artery, which significantly reduces blood loss. IN Lately removal of angiofibroma is carried out using endoscopic methods, which significantly reduces the invasiveness of the operation

IN postoperative period infusion, hemostatic, antibacterial therapy; if necessary, external gamma radiation therapy. In VTEC at the place of residence, a disability group is issued in inoperable cases

The prognosis for timely tumor removal is favorable.

nose pharynx ear papilloma

Benign tumors of the larynx

Among benign tumors of the larynx, the most common are papillomas and vascular tumors.

Papilloma is a benign fibroepithelial tumor of the upper respiratory tract, representing single or more often multiple papillary outgrowths, leading to disruption of voice production and respiratory functions, often recurrent.

The etiological factor of papillomatosis is the human papillomavirus from the papovavirus family. Currently, more than 70 types of this virus have been identified, but with papillomatosis, types 6, 11, or a combination of them are more often found. The disease occurs in children under 10 years of age, but most often between 2 and 5 years of age. Papilloma, like a number of other benign tumors, grows unevenly: periods intensive growth are replaced by periods of relative calm. During puberty, a cessation of growth of papillomas is often observed, but if the tumor persists in an adult, then the probability of its malignancy increases sharply and amounts to 15-20%.

Histologically, papillomas consist of connective tissue stroma and stratified squamous epithelium, clearly delimited from each other by a basement membrane. Depending on quantity connective tissue In the tumor stroma, hard and soft papillomas are distinguished. Papillomas usually have a wide base and occasionally a small stalk. They are most often localized in the area of ​​the commissure and the anterior third of the vocal folds. From the middle section, papillomatosis can spread to the entire larynx and beyond. In shape and appearance, the surface of the papilloma resembles a mulberry or cauliflower; the color is usually pale pink, sometimes with a grayish tint

The main symptoms of the disease are hoarseness, reaching aphonia, and gradual difficulty breathing, which can develop into suffocation as a result of obstruction of the lumen of the larynx by a tumor.

Diagnostics. Based on the characteristic endoscopic picture and the results of histological examination of the biopsy material. Inspection and manipulation of the larynx in children are performed under anesthesia with direct laryngoscopy in adults. In adults, the main method of examination is indirect laryngoscopy. Currently, microlaryngoscopy is a highly informative method for examining the larynx.

Treatment. Papillomas can be removed in adults under local anesthesia endolaryngeally with indirect laryngoscopy, in children - always under anesthesia using direct endomicrolaryngoscopy followed by histological examination. Sometimes, if all parts of the larynx are affected, it is not possible to completely remove the tumor at one time, so the intervention is performed in several stages. One should strive for timely intervention in the larynx before the need for a tracheostomy arises, since tracheal cannulation promotes the spread of papillomas to the trachea and even the bronchi.

Ultrasonic disintegration of papillomas has proven effective, as well as laser photodestruction, for which surgical CO2 laser, YAG-neodymium and YAG-holmium lasers are used. High precision of the laser beam, the ability to remove papillomas from hard-to-reach parts of the larynx, low bleeding, and a good functional effect were noted.

In order to reduce relapses of papillomatosis, a fairly significant arsenal is used medicinal products: prospididia intramuscularly, intravenously and locally in the form of an ointment: interferon preparations (reaferon, viferon, intron-A); leukomax, zaveron (acyclovir), discrete plasmapheresis, etc.

Angioma is a benign vascular tumor of the larynx, formed from dilated blood vessels (hemangiomas) or lymphatic vessels (lymphangiomas), localized on the surface of the vocal, vestibular or aryepiglottic folds.

Angioma grows slowly and is usually single and small in size. The color of the hemangioma is bluish or red; lymphangioma has a pale yellow color. Hemangiomas can be diffuse and encapsulated.

Clinical manifestations of angioma depend on the location and extent of the tumor. When localized in the upper part of the larynx, the sensation of a foreign body and sometimes coughing are disturbing. Gradually, over several years, the symptoms increase, hoarseness, pain, and then blood in the sputum appear. If the tumor comes from the vocal fold, then the first symptom is a gradual change in the voice from slight weakness to aphonia. Breathing disturbance is typical for large tumors arising from the lower part of the larynx.

Treatment of angiomas is surgical, most often performed through endolaryngeal access. The possibility of intraoperative bleeding should be taken into account. Common hemangiomas are removed through external access with preliminary tracheostomy.

Benign ear tumors

Among benign neoplasms of the external vxa, papilloma is a rare tumor of epithelial origin, usually located on the skin of the external auditory canal and on auricle. Papilloma grows slowly and rarely reaches large sizes. Treatment is surgical, diathermocoagulation, cryo- or laser destruction.

Osteoma is localized in the bony part of the external auditory canal, develops from a compact layer of the posterior, less often upper or bottom walls. It can be in the form of exostosis on a thin stalk, the recognition and removal of which is usually not difficult. In other cases, it is hyperostosis, which has a wide flat base, partially or completely covering the lumen of the external auditory canal: sometimes hyperostosis is located in the annulus tympanicus area and even extends to the walls tympanic cavity. In these cases it surgical removal carried out by postauricular access. Endophytic growth of osteoma into the thickness of the mastoid process is possible.

Hemangioma in the ear area is uncommon. Predominantly cavernous encapsulated capillary (superficial and deep), branched (arterial and venous) hemangiomas are observed. Hemangiomas can be localized in any part of the ear, but more often they occur in the outer ear. Vascular tumors of the middle ear grow slowly, can destroy surrounding tissue and extend far beyond the ear. Some of them may ulcerate and be accompanied by intense bleeding. Treatment is surgical.

Of the benign tumors of the middle ear, chemodectoma deserves attention, developing from glomus corpuscles contained in the mucous membrane of the tympanic cavity and located along the nerve fibers and blood vessels. Glomus accumulations are localized in the adventitia of the superior bulb of the internal jugular vein and thicker than a pyramid temporal bone. If a chemodectoma develops from the glomus bodies of the tympanic cavity, then subjectively at an early stage it manifests itself as pulsating noise in the ear and hearing loss; these symptoms increase rapidly. As the chemodectome grows, it gradually fills the middle cavity and shines through eardrum, then can destroy it and appears in the external ear canal. It should be noted that the initial signs of hemangiomas and chemodectomas of the tympanic cavity are largely similar, however, bleeding from the ear is observed with hemangiomas; they are not typical for chemodectomas. Tumors can destroy the bone walls of the tympanic cavity and spread to the base of the skull or penetrate into its cavity. The spread of the tumor into the cranial cavity is indicated by the appearance of signs of irritation meninges and lesions IX, X and XI cranial nerves. These signs appear quite early if the tumor primarily arises in the area of ​​the jugular fossa (from the jugular glomus).

For hemangiomas and chemodectomas, a positive Brown test is described: an increase in air pressure in the external auditory canal is accompanied by pulsation of the tumor, and the patient cancels the appearance or intensification of pulsating noise in the ear. When the vessels in the neck are compressed, the pulsating noise decreases or stops, while the hemangioma sometimes turns pale and decreases in size. Additional method diagnosis of these tumors is selective angiography. It allows you to clarify the boundaries of the tumor, the condition of the jugular vein, and identify the vessels supplying the tumor. Reliable diagnostic methods are CT and MRI.

Treatment of patients with benign tumors of the middle ear is mainly surgical. Timely removal of these tumors should be considered as an effective measure to prevent their malignancy. Surgeries for chemodectomas and hemangiomas are accompanied by intense bleeding. Preliminary ligation of the external carotid artery and embolization of small blood vessels for tumors of this location turned out to be ineffective. Cryotherapy during the operation also did not live up to initial hopes for the possibility of bloodless tumor removal. For tumors that do not extend beyond the tympanic cavity, endaural tympanotomy or atticoanthrotomy is limited. If the tumor extends into the external auditory canal, trepanation of the mastoid process is performed.

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Diseases of the ENT organs various types are diagnosed several times more often than other pathologies. They may wear non-infectious or infectious nature. But benign or malignant neoplasms that form on the tissues of the ENT organs are also identified.

What's happened

Formations of ENT organs include a large number various tumors and growths that are localized on the nasal mucosa and oral cavity, upper respiratory tract and middle or outer ear area.

They represent both various growths that are attached using a stalk or a wide base, as well as neoplasms. They can have a malignant or benign course.

Classification

In medicine, there are two main types of tumors that affect the nasopharynx and middle ear. They differ in the nature of the flow and have certain features.

Benign

They are classified according to their characteristics and appearance. Main feature formations is their slow growth and absence unpleasant symptoms.

Among such formations that have a benign course are:

• moles;
• warts;
• fibroids;
• chondromas;
• neuromas;
• polyps;
• papillomas;
• angiomas.

All of them do not have a tumor structure. Such growths represent hyperplasia of the mucous membrane of an allergic or inflammatory nature.

Clinical manifestations occur in the later stages of their formation, when growths and formations reach a significant size. But they also pose a danger to the life and health of the patient, since with regular injury, inflammation and bleeding, they can degenerate into malignant neoplasms.

Benign tumors form on the mucous membranes of the nasal and oral cavities, in the nasopharynx, ear canal and upper respiratory tract.

Malignant

Neoplasms that form on the mucous membrane of the ENT organs can also be malignant.

They have an aggressive course, are accompanied by many unpleasant signs and cause the development of serious complications. They are classified depending on the area of ​​localization pathological process.

Nose cancer

The disease is diagnosed mainly in middle-aged, older and elderly men. The main way to determine the presence of formations on the nasal mucosa is rhinoscopy.

In the early stages of pathology development, certain signs are absent. As the tumor grows, bleeding, difficulty breathing, and pain are noted.

Nasopharyngeal cancer

The diagnosis is established in men over 45 years of age. The main sign on early stages are frequent sinusitis. Over time, pus and mucus mixed with blood are released from the nasal cavity.

For nasopharyngeal cancer, surgical removal is not possible. Other methods are used for treatment.

Laryngeal cancer

Usually occurs in female patients. The disease at the initial stage is characterized by a sore throat.

The pathology proceeds aggressively, the pathological process spreads rapidly, and in short time affects healthy surrounding tissues.

Throat and mouth cancer

It is installed mainly in children and adolescents. Distinctive feature diseases is the presence of visible signs of a pathological process.

If not treated promptly, mutated cells quickly spread and affect surrounding tissues.

Outer and middle ear cancer

The disease is determined by visual examination. The main signs are a decrease in the quality of hearing, the appearance purulent discharge, headaches.

In some cases, the pathological process may spread to facial nerve, which leads to a number of other unpleasant symptoms.

Causes

Scientists have not established the true reasons for the development of tumors of the ENT organs. But even today experts are conducting a lot of research. This will allow us to identify certain preventive measures that will protect a person from the development of such diseases.

Scientists have only been able to establish a number of factors that can increase the likelihood of the formation of various types of tumors.

First of all, it is believed that the main provocateur is genetic predisposition. Many patients had close relatives suffering from similar diseases.

Experts also believe that provoking factors may be exposure to chemicals, toxic substances or ultraviolet rays, bad habits, and poor nutrition.

Clinical picture

In the early stages, there are most often no signs of the disease. As the malignant tumors ENT organs observed the occurrence common features. These include headaches, weakness, fast fatiguability, loss of appetite.

At later stages, metastatic lesions appear in distant organs and tissues, pain occurs in the affected area, and breathing becomes difficult.

In some cases, shortness of breath, decreased quality of hearing, nosebleeds, and the appearance of purulent discharge from the nose, which includes blood clots, are noted. Hoarseness and sore throat are also observed.

Diagnostics

If there are complaints, the specialist first conducts a survey and examination of the patient. Also studies anamnesis. Based on the data obtained, it is established preliminary diagnosis. To clarify it, use instrumental methods research.

The main method for identifying tumors on the nasal mucosa is rhinoscopy, in which an endoscope is inserted into the nasal passage. This allows you to visualize the tumor and conduct a detailed study of it.

The patient is also prescribed an MRI or CT scan. Techniques are used to determine the extent of damage.

In order to determine the nature of the course, a biopsy is prescribed. In cases where the results of the study reveal a malignant formation, radiography is prescribed. The method is used to determine the presence of metastatic lesions.

An accurate diagnosis is established based on all diagnostic results.

Treatment

The main method of treating formations is surgery. Depending on the stage of development, the surgeon removes only the affected tissue or the formation along with surrounding tissue.

But removal of benign tumors is carried out if there is a risk of their degeneration into cancerous formations or they cause discomfort.

If it is impossible to remove a malignant tumor due to its localization, chemotherapy or radiation therapy is prescribed.

Complications

Cancers are not only characterized by an aggressive course, but are also capable of affecting the functioning of other organs as a result of the spread of metastatic lesions. Lack of therapy leads to death due to cardiac, renal, pulmonary or liver failure.

Benign formations in some cases also pose dangers, as they can mutate into cancerous tumors under the influence of external and internal factors.

Prognosis and prevention

The prognosis depends on the nature of the pathology. For benign neoplasms, it is most often favorable.

But when cancerous tumors are diagnosed, the five-year survival rate of patients ranges from 80 to 10%, depending on the stage of development of the pathological process.

As a preventative measure, experts recommend eating right, avoiding bad habits, eliminate exposure to chemicals and regularly undergo preventive tests. When working on hazardous production nessesary to use individual means protection.

Neoplasms of the ENT organs are often diagnosed and can have a malignant course, which leads to a number of complications in the absence of therapy. That is why, if unpleasant symptoms appear, you should immediately consult a doctor for diagnosis.

To exclude the development of certain consequences, including fatal outcome, allow only timely treatment.

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Symptoms

• Facial skin defect;
• Difficulty swallowing;
• Hoarseness of voice;

Diagnostics

Treatment

. This technology (IMRT) allows you to direct a beam of rays directly into the tumor. The entire dosage and radiation technique is based on matching the shape of the tumor in three-dimensional space, without affecting healthy tissue. The effect on healthy cells is reduced to a minimum. In oncology centers abroad, before prescribing radiotherapy to a patient, he is examined by a radiation oncologist, studies all available data about the disease, and takes into account individual characteristics offers optimal treatment options. The patient is also examined by a pathologist and surgeon. Before starting radiotherapy, specialists perform a simulation of therapy using a CT machine, which allows you to accurately calculate the radiation dose and duration of treatment. After this, radiation therapy begins within 2 or 3 days. It can be done 1 or 2 times a day, five times a week. Radiotherapy can last a month or two, depending on the individual capabilities of the patient’s body and the needs of the treatment process. The first few procedures last about an hour, and subsequent sessions are carried out over several minutes. During the treatment process the patient does not experience any painful sensations. Side effects of radiotherapy usually begin no earlier than the second week of treatment. Treatment specialists warn about possible side effects that occur depending on the location of the tumor, as well as the extent of the tumor's spread and the intensity of therapy. In modern oncology, new developments are constantly being applied in the fight against head and neck cancer. Doctors combine old treatment methods with new ones to obtain maximum effect: a combination of chemo-radiotherapy or immunotherapy for growing tumors. Recently, drugs that increase sensitivity have also been used effectively. malignant formation to radiotherapy. Due to the fact that many patients with ENT cancer begin treatment in advanced stages, the prognosis is not always favorable. It all depends on the stage of the disease. The average five-year survival rate is 45-55%. ENT services abroad are an opportunity to make maximum use of all the achievements of modern medicine for recovery. We offer treatment in the best medical centers Israel, Germany and other countries. Contact us without delay! A medical consultant will call you back and provide detailed information on the possibilities of arrival. => 21 => 4 => raw => 8 => => 12 => 4 => Malignant neoplasms quite often develop in the head and neck area. Of all the malignant tumors that form in the head and neck area (ENT oncology), the most common is squamous cell carcinoma. This tumor arises from cells lining the pharynx, mouth and nasal cavity from the inside. Diseases such as tumors are also common salivary glands, sarcomas, lymphomas. Cancer spreads in three ways:

• Metastasis of cancer cells from the original focus to nearby tissues.
• Hematogenous method, when cancer cells move through blood vessels to other organs and tissues.
• Lymphogenic is when the tumor spreads through lymphatic vessels. Tumors that form in the head or neck most often metastasize in the lymphogenous way.

Cancers of the head and neck often affect the lymph nodes. Often the target of the lesion is a node in the area of ​​the internal jugular vein. The likelihood of further spread of the formation through the blood vessels is largely determined by the degree of damage, the number and location of the lymph nodes in the neck. The risk of spread of metastases increases with damage to the lymph nodes in the lower parts of the neck.

Symptoms

The clinical picture of tumors in the head and neck region depends on the location of the tumor and the stage of the disease. The most commonly observed symptoms are:

• The presence of a defect in the mucous membrane of the oral cavity, nose;
• Facial skin defect;
• Increase in regional lymph nodes;
• Difficulty swallowing;
• Hoarseness of voice;
• Unmotivated weakness, loss of appetite, emaciation and increased body temperature.

Diagnostics

A general clinical examination plays an important role in the diagnosis of ENT oncology. Experienced oncologists may already have reason to suggest a diagnosis based on the examination. Next, the patient is asked to undergo a series of additional studies. The main method for diagnosing head and neck cancer is a tumor biopsy followed by histological examination of the material.

Treatment

Treatment tactics for ENT oncology depend on the advanced stage of the process and are selected individually for each patient. Results are taken into account medical research, age, general state the patient’s health, the presence or absence of concomitant somatic pathologies. Treatment of malignant tumors of the ENT organs is carried out using surgical intervention, radiation therapy, chemotherapy. Most often these methods are combined. Treatment usually begins with radiation therapy, which is aimed at reducing the size of the tumor. This is followed by surgical removal malignant neoplasm. The final stage Chemotherapy is used in the treatment of oncopathology of the ENT organs. One common treatment method is external beam radiation therapy, which sends a focused beam of X-rays directly to the tumor. The radiation is generated by a linear accelerator and concentrated on the pathological area. X-ray radiation kills abnormal cells, while healthy tissues and organs remain unaffected. Modern radiotherapy shows high effectiveness in the treatment of head and neck cancer. This treatment method is used by oncologists at cancer treatment centers around the world. There is also a newer method of radiotherapy using computerized linear accelerators called intensity modulated radiotherapy . This technology (IMRT) allows you to direct a beam of rays directly into the tumor. The entire dosage and radiation technique is based on matching the shape of the tumor in three-dimensional space, without affecting healthy tissue. The effect on healthy cells is reduced to a minimum. In oncology centers abroad, before prescribing radiotherapy to a patient, he is examined by a radiation oncologist, studies all available data about the disease, and, taking into account individual characteristics, offers optimal treatment options. The patient is also examined by a pathologist and surgeon. Before starting radiotherapy, specialists perform a simulation of therapy using a CT machine, which allows you to accurately calculate the radiation dose and duration of treatment. After this, radiation therapy begins within 2 or 3 days. It can be done 1 or 2 times a day, five times a week. Radiotherapy can last a month or two, depending on the individual capabilities of the patient’s body and the needs of the treatment process. The first few procedures last about an hour, and subsequent sessions are carried out over several minutes. During the treatment process, the patient does not experience any pain. Side effects of radiotherapy usually begin no earlier than the second week of treatment. Treatment specialists warn about possible side effects that occur depending on the location of the tumor, as well as the extent of the tumor's spread and the intensity of therapy. In modern oncology, new developments are constantly being applied in the fight against head and neck cancer. Doctors combine old treatment methods with new ones to obtain maximum effect: a combination of chemo-radiotherapy or immunotherapy for growing tumors. Recently, drugs that increase the sensitivity of malignant tumors to radiotherapy have also been effectively used. Due to the fact that many patients with ENT cancer begin treatment in advanced stages, the prognosis is not always favorable. It all depends on the stage of the disease. The average five-year survival rate is 45-55%. ENT services abroad are an opportunity to make maximum use of all the achievements of modern medicine for recovery. We offer treatment in the best medical centers in Israel, Germany and other countries. Contact us without delay! A medical consultant will call you back and provide detailed information on the possibilities of arrival. => ENT-Oncology => lor => 21)

Malignant tumors of the ENT organs can develop from a number of relatively benign growths (malignancy) that precede them, which are called pretumors. In addition to the direct effect of the tumor on the surrounding tissues and organs in which it arose, tumors are also characterized by so-called paraneoplastic syndromes, which are nonspecific in nature and accompany not only malignant growth, but also some benign tumors, for example, neuroma of the vestibulocochlear nerve, which develops in the internal ear canal, compressing the nerve trunks corresponding to their localization.

Paraneoplastic syndromes are a variety of pathological manifestations caused by the influence of the tumor process on metabolism and the functional activity of the body's regulatory systems. For the most part, these syndromes aggravate the course of the tumor process, and in some cases their signs help diagnose the disease. Over 60 paraneoplastic syndromes have been described, among which are syndromes with disorders metabolic processes, endocrine functions, skin lesions, vascular disorders, autoimmune disorders, allergic reactions, central nervous system lesions, neuromuscular disorders, etc. The incidence of tumors increases with age, and in most cases they occur after 40 years. However, some tumors are more common in children than in adults. These include teratomas - neoplasms from embryonic tissue, tumors from nervous tissue, peculiar kidney tumors (nephroblastomas) and various angiomas - vascular tumors.

Symptoms of malignant tumors of the ENT organs

It is generally accepted that malignant tumors in initial stages are asymptomatic, but in most cases, with a careful and in-depth history, one or more minor symptoms can be identified general oncological disease (deterioration of well-being, increased fatigue, loss of appetite, weakness, etc.), but if a tumor or its predecessor - a pretumor - develops in an organ whose function is obvious to both the patient and others (for example, the phonatory function of the larynx), then these small symptoms must be taken into account while observing the principle of oncological vigilance. The symptoms of each form of malignant (benign) tumor depend on its location and degree of spread, which is usually designated according to the International System, where T is the primary tumor focus, N is damage to the lymph nodes, M is the presence of hematogenous metastases in distant organs. The degree of expression of each of these signs is characterized by digital indicators. There is a classification in which everything clinical manifestations Tumor growth is divided into stages:

• stage I - the tumor is limited to the organ, there are no metastases;
• stage II - tumor within the affected organ, there are metastases in regional lymph nodes;
• stage III - a tumor of significant size with invasion into adjacent organs and tissues, there are multiple metastases in regional lymph nodes;
• stage IV - the presence of distant metastases, regardless of the size and extent of the primary tumor.

Diagnosis of malignant tumors of the ENT organs

Diagnosis of malignant tumors of the ENT organs is carried out using the same methods as the recognition of other diseases. Early recognition of oncological diseases of organs accessible to visual examination is most easily possible, since this allows not only their examination, but also the collection of material for morphological examination. Early diagnosis of tumors is most difficult internal organs. In this case, special research methods become crucial: X-ray, radionuclide, morphological, immunological, etc. clinical practice research methods using nuclides are increasingly being introduced, called radionuclide diagnostics, which is a method of recognition pathological changes human organs and systems using radiopharmaceuticals, which include compounds labeled with radionuclides. Registration of the effects of radionuclides introduced into the body is carried out using scintigraphy, scanning, radiometry, and radiography. Scintigraphy, the most common method of radionuclide diagnostics, allows you to obtain an image of an organ and use it to judge its size and shape, identify the lesion in the form of an area of ​​​​increased or decreased accumulation of the injected radionuclide, evaluate functional state organ according to the rate of accumulation and release of the radiopharmaceutical. The use of radionuclide diagnostics due to the extremely low dose of the nuclide, its short half-life and rapid elimination does not pose a danger to the body. The final stage of diagnosis is a morphological study, which is carried out using histological (biopsy) or cytological methods for studying cells in washings and scrapings from the affected area. According to the method of taking material for histological examination, they distinguish between incisional, puncture and aspiration biopsy. In this case, preliminary tissue dissection may be required to provide access to a deep-lying lesion (open biopsy). For tumors of the upper respiratory tract, incisional biopsy is most often used due to the accessibility of the study object. When examining the trachea and bronchi, aspiration biopsy of sputum and swabs is used. A biopsy is performed only in a medical facility, strictly observing the requirements of asepsis and taking into account the general condition of the patient. The resulting material is immediately placed in a freshly prepared fixing solution containing 1 part formalin and 4-5 parts water, and, together with the accompanying document completed by the doctor, is delivered to the laboratory of the pathology department.

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