Laryngectomy, cancers, Radiotherapy, Laryngeal conservation, late presentation.
Abstract
Background: We undertook this study to detect emerging pattern in the challenges in managing patients with laryngeal cancer in our setting. Methodology: We review the 16 patients with histologically confirmed laryngeal carcinoma managed at the Otorhinolaryngology Head and Neck surgery Department of Obafemi Awolowo University Teaching Hospitals complex between 1st January 2008 and 31st December 2013. Result: There were 11 males and 5 females with mean age of 58.0 years. Three (18.8%) patients who were all males had history of smoking. History of significant alcohol intake was found in 4 (25.0 %) males and 1 (6.3%) female. Fifteen (93.8%) patients presented as an emergency with airway obstruction necessitating emergency tracheostomy. Eight (50.0%)patients had total laryngectomy as primary treatment modality and 1 (6.25%) patient had radical radiotherapy as her primary treatment modality. Six (37.5%) patients refused further treatments after their initial emergency Tracheostomy, Laryngoscopy and Biopsy and were subsequently lost to follow up. One (6.35%) patient died before commencement of definitive treatment. Among the laryngectomy group, 2 (12.5%) died on admission, 2 (12.5%) was lost to follow up and1 (6.25%) had stoma recurrence; Three (18.75%) patients are alive. All the patients with loco-regional failure had it within 18 months with only 1 (6.25%) survival at 2 years. Conclusion: Late presentation and treatment refusal remain the major challenges in this study. There is thus an urgent need for health education to promote early presentation.
