control of the airflow during breathing protection of the airway production of sound for speech

Tidak diketahui berhubungan dengan karsinogen : tembakau, alkohol, polusi industri laringitis kronik penggunaan suara berlebihan Herediter Laki-laki > wanita 50 70 th Squamous cell carcinoma

Pada glotis (pita suara) diatas glotis (supraglotis atau false vocal cord) dibawah glotis (subglotis)

Stage I : T1, N0 and M0. Stage II :T2, N0 and M0. Stage III : T3, N0 and M0; also T1, T2, or T3, and N1, M0. Stage IV : T4, N0 or N1, M0; any T with N2 or N3 and M0, or M1 with any T or N level.

T1 Tumor at just one site of the larynx. T2 Tumor at two sites of the larynx. T3 Tumor in the larynx that has caused one of the vocal cords to stop moving. T4 Tumor that has extended beyond the larynx.

N0 No evidence of any spread to the neck. N1 One suspicious lymph node that is less than 3 cm ( 1.25 inches) in diameter. N2 Suspicous nodes on both sides of the neck, or more than one suspicious node on one side, or a large node on one side, up to 6 cm (2.5 inches). N3 A suspicious node that is bigger than 6 cm in diameter.

M0 No metastisis. M1 Metastasis present.

Serak yang menetap bengkak atau benjolan di tenggorokan disfagia, nyeri ketika bicara rasa terbakar di tenggorokan saat menelan cairan panas dyspnea, lemah, penurunan BB pembesaraan kelenjar limfe, nyeri Nafas bau

Laryngoscopy Menegakkan dx dan identifikasi tipe keganasan biopsi CT scan Mendeteksi metastase Rontgen dada dan ukuran tumor pergerakan pita suara

Treatment tergantung pada ukuran lesi, usia klien, ada/tdknya metastasis Medical treatment :

chemoterapy terapi radiasi :

Jika hanya 1 pita suara yang terkena Suara norrmal Pre op u/ ukuran tumor Perawatan tdk terlalu lama

pembedahan :
pembedahan laser partial/total laryngectomy

Obstruksi jalan nafas Perdarahan Ruptur arteri karotid Pembentukan fistula Stenosis trakeostomi

PENGKAJIAN
Preoperatif :

* tanda dan gejala * tingkat pemahaman klien ttg dx, alasan pembedahan, dan hasil pembedahan postoperassi :
kepatenan jalan nafas keefeektifan bersihan jalan nafas Komunikasi Support sistem

Bersihan jalan nafas tidak efektif Gangguan komunikasi verbal Resiko Infeksi Nyeri Resiko gangguan memberan mukosa oral Isolasi sosial Kurang Pengetahuan Cemas

Bersihan jalan nafas tdk efektif

Airway management Semi-fowlers or higher Observe hypoxia Stoma care Maintain suction Keep stoma free of mucus Maintain tube 3-6 weeks

Speech terapiest Magic slate Picture-word-phrase board Esophageal speech Electro-larynx Tracheoesophageal puncture

NPO 10 14 days NG and TPN for nutrition Thick fluids introduced first Avoid sweet foods Rinse mounth or brush teeth after eating

Positive approach Promote self care Allow to ventilate feelings Support groups

Teach ways to handle increase mucus production Keep stoma clear of excess mucus Cleanse peri-stoma skin Use nebbulizer or humidifier Assure that taste and smell will adapt over time Cover stoma while showering

Avoid swimming Avoid powders and aerosols Carry medical alert information

Monitor for respiratory distress Monitor for mucus plug Watch for bleeding at incision site Watch for respiratory infection