Head and Neck Cancer Overview

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Questions and Answers

What is the primary reason for maintaining airway and gas exchange post-neck dissection?

  • To minimize pain
  • To manage potential airway obstruction (correct)
  • To prevent hypotension
  • To reduce the risk of aspiration

During the postoperative monitoring of a patient in the ICU after neck dissection, which of the following signs would most likely indicate a serious complication?

  • Blood tinged secretions
  • Bright red blood spurting from the site (correct)
  • Increased pain level
  • Mild swelling at the incision

What is the appropriate way to manage a carotid artery rupture post-neck dissection?

  • Hold continuous direct pressure to the site and secure airway (correct)
  • Notify the surgeon and wait for instructions
  • Position the patient upright and relax
  • Apply pressure and monitor

Which technique should be taught to patients who have undergone a partial laryngectomy to help with swallowing?

<p>Supraglottic method of swallowing (B)</p> Signup and view all the answers

What should be the appearance of the stoma after neck dissection surgery as part of post-operative evaluations?

<p>Bright pink and shiny without crusts (A)</p> Signup and view all the answers

What should be monitored in the donor site after a graft or flap procedure following neck dissection?

<p>Color and drainage (B)</p> Signup and view all the answers

What communication method is recommended for patients who have undergone total laryngectomy?

<p>Use of a communication board (C)</p> Signup and view all the answers

Which intervention is crucial for preventing aspiration in patients after neck dissection?

<p>Promoting deep breathing and coughing exercises (B)</p> Signup and view all the answers

What is the primary risk factor associated with head and neck cancers?

<p>Chronic laryngitis (C)</p> Signup and view all the answers

Which diagnostic test is most closely associated with determining the presence of metastasis in cancer patients?

<p>PET scan (B)</p> Signup and view all the answers

Which substance is phenylephrine found in?

<p>Decongestants (B)</p> Signup and view all the answers

What is the first visual sign associated with head and neck cancers?

<p>Leukoplakia (A)</p> Signup and view all the answers

What is a common side effect of radiation therapy for head and neck cancers?

<p>Dry mouth (A)</p> Signup and view all the answers

Which treatment option is specifically tailored to target epidermal growth factor receptors in head and neck cancers?

<p>Biotherapy (C)</p> Signup and view all the answers

What action should be avoided during a nosebleed to prevent further bleeding?

<p>Blowing the nose (D)</p> Signup and view all the answers

What procedure may be indicated as a last resort for dealing with large tumors in the larynx?

<p>Laryngectomy (C)</p> Signup and view all the answers

Which intervention is recommended for managing hoarseness after radiation therapy?

<p>Vocal rest (D)</p> Signup and view all the answers

What finding in a CBC may indicate chronic bleeding leading to anemia?

<p>Thrombocytopenia (A)</p> Signup and view all the answers

What symptom is correlated with voice changes due to a tumor in the head and neck region?

<p>New onset of hoarseness (B)</p> Signup and view all the answers

In which type of biopsy is there a higher risk of spreading cancer due to the method of sampling?

<p>Open incision biopsy (A)</p> Signup and view all the answers

What dietary intervention might be considered for a patient undergoing treatment for head and neck cancer?

<p>High protein diet (D)</p> Signup and view all the answers

What is a notable sign that indicates the need for urgent medical attention during an epistaxis?

<p>Continued bleeding over 20 minutes (B)</p> Signup and view all the answers

Flashcards

Phenylephrine's Placebo Effect

Phenylephrine, a common decongestant, is not more effective than a placebo.

Epistaxis

A nosebleed.

Posterior Nasal Bleed

A nosebleed originating from the back of the nasal cavity; more severe.

Head & Neck Cancer

Cancers of the head and neck region; often squamous cell carcinomas.

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Leukoplakia

White patches in the mouth or around the mouth, possibly a sign of cancer.

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Erythroplakia

Red patches in the mouth or around the mouth; possibly cancer.

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Head & Neck Cancer Risk Factors

Smoking, alcohol abuse, chronic GERD, chronic vocal abuse, certain work environments, & HPV (especially oral) are all associated with increased risk.

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Head & Neck Cancer Treatment Team

A multidisciplinary team of medical professionals (oncologists, nutritionists, SLP, respiratory therapists, etc.), helps manage the complex needs of head and neck cancer patients.

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Head & Neck Cancer Assessment

Involves a comprehensive history of risk factors, assessment of oral/oropharyngeal structures, and checking for warning signs.

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Head & Neck Cancer Diagnostics

Involves lab tests (CBC, BMP, bleeding times, urinalysis), imaging (x-rays, CT, MRI, PET scans), and endoscopic exams to diagnose and stage the cancer.

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Fine-Needle Biopsy

A specific biopsy method to confirm the presence of head and neck cancer.

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Head & Neck Cancer Interventions

Treatment strategies include radiation therapy, chemotherapy, surgery, and targeted therapy.

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Radiation Therapy for Head & Neck Cancer

A type of cancer treatment that uses high-energy radiation to destroy cancer cells.

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Chemotherapy for Head & Neck Cancer

A type of cancer treatment that uses drugs to destroy cancer cells.

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Targeted Therapy for Head & Neck Cancer

Uses drugs that target specific proteins or pathways involved in cancer cell growth and survival

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Surgical Interventions for Head & Neck Cancer

Procedures such as laryngectomies, tracheotomies, and/or tumor resections to remove cancer tissue.

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Preoperative Surgical Care

Care provided before a surgery for head and neck cancer patients. Includes patient and family education, support and self-management techniques related to the planned surgical steps, and early steps for communication recovery that may include SLP.

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Neck dissection

Surgical removal of lymph nodes, SCM muscle, jugular vein, CN11 and surrounding tissue in the neck.

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Postoperative airway monitoring

Continuous monitoring of the airway, typically every hour, for the first 24 hours after surgery.

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Carotid artery rupture

A serious complication of neck surgery where the carotid artery bursts, causing rapid bleeding.

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Airway obstruction

Blockage of the airway, potentially caused by secretions, or hematomas after a neck surgery (or similar procedures).

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Hemorrhage

Excessive bleeding.

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Wound breakdown

An open wound which fails to heal

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Tumor recurrence

The regrowth of cancer cells at the original or other sites.

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Postoperative Interventions

Actions taken after surgery to maintain health, and prevent further complications.

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Total laryngectomy

Surgical removal of the entire larynx (voice box).

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Stoma care

Cleaning and monitoring of the surgical opening (stoma) for proper healing.

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Pain management

Methods for controlling post-surgical pain, often with PCA pumps initially and transitioning to oral options.

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Communication support

Helping patients communicate, especially after procedures affecting speech capabilities.

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Psychosocial support

Support and care needed for patient's emotional and mental well-being, especially after large, life-altering, or facial surgical procedures.

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Home care management

Guidance and support for patients at home, including tracheostomy or stoma care instructions, nutritional management, and communication methods.

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Study Notes

Neck Dissection: Postoperative Management

  • Maintaining airway and gas exchange is essential post-neck dissection to prevent complications due to potential damage to the airway, nerves, and blood vessels during surgery.
  • Stridor: This is a harsh, high-pitched sound during breathing, indicating airway obstruction and a possible life-threatening complication.
  • Carotid artery rupture requires immediate surgical intervention and control of bleeding. Techniques like direct pressure, clamping, and vascular repair are employed.
  • Swallowing exercises: Teaching the supraglottic swallow technique can enhance swallowing function and reduce aspiration risk after partial laryngectomy.
  • Stoma appearance: After neck dissection surgery, the stoma should be pink and moist with minimal drainage. This suggests proper healing and adequate blood supply.
  • Donor site monitoring: Monitor the color, temperature, and capillary refill of the donor site after a graft or flap procedure to detect potential complications like ischemia or infection.
  • Total laryngectomy communication: Esophageal speech is a preferred communication method for patients who have undergone total laryngectomy, as they can't speak through their larynx anymore.
  • Preventing aspiration: Elevate the head of the bed during sleep can help prevent aspiration in patients after neck dissection due to potential swallowing difficulties.

Head and Neck Cancers

  • Tobacco use is a major risk factor for head and neck cancers.
  • Metastasis determination: Biopsy and imaging tests are crucial for assessing the spread of cancer.
  • Phenylephrine: This decongestant is found in nasal sprays and eye drops.
  • Early visual sign: A lump or sore that doesn't heal is a common initial sign of head and neck cancer.
  • Radiation therapy side effect: Xerostomia (dry mouth) is a frequent side effect of radiation therapy for head and neck cancers.
  • Epidermal growth factor receptor (EGFR) targeting: Cetuximab is an example of a drug that specifically targets EGFR in head and neck cancers.
  • Action to avoid during nosebleed: Blowing the nose can worsen bleeding by dislodging clots and increasing pressure in nasal vessels.
  • Last resort for large laryngeal tumors: Laryngectomy may be required to remove large tumors in the larynx, aiming to preserve life.
  • Managing hoarseness after radiation: Voice therapy can help improve voice quality and function affected by radiation therapy.

Head and Neck Cancer: Diagnosis and Management

  • Low red blood cell count (RBC) in a CBC may indicate chronic bleeding leading to anemia, a potential sign of head and neck cancer progression.
  • Voice changes: Hoarseness and changes in voice quality can be a major symptom of a tumor in the head and neck region.
  • Biopsy type with higher spread risk: Fine needle aspiration biopsy may increase the risk of cancer spread due to the small sample size and potential for tumor cell dispersion.
  • Dietary intervention: A soft and easily digestible diet might be necessary for patients undergoing head and neck cancer treatment to manage swallowing difficulties and side effects.
  • Urgent epistaxis sign: Bright red, pulsating blood from the nose indicates severe bleeding and necessitates immediate medical attention.

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