Highlights in the evolution of diagnosis and treatment of laryngeal cancer.

Abstract

To present selected highlights from the evolution of diagnosis of laryngeal disease and treatment of laryngeal cancer from ancient Greece until the 20th century. Historical study of diagnosis of laryngeal disease and treatment of laryngeal cancer from the ancient Greek medical scriptures until the most recent evolutional steps in the 20th century. Original Greek-language texts of ancient and Byzantine medical writers were studied and literature on history of medicine was investigated to reveal early knowledge of diagnostic and therapeutic techniques for laryngeal disease and cancer of the larynx. Diseases of the upper aerodigestive tract were known and treated by ancient Greek physicians, and, later, Byzantine doctors, apart from preserving ancient medical concepts, contributed their own ideas, mainly about surgery and postoperative care. The initial therapeutic approach for the disorders caused by laryngeal tumors was either tracheotomy or endotracheal intubation in an attempt to prevent suffocation. In more recent times, construction of the laryngoscope and other modern examination instruments, as well as the final acceptance of histological diagnosis based on tissue biopsy, has allowed for accurate diagnosis and successful treatment of laryngeal lesions. Preoperational biopsy, application of pharyngoesophageal speech and advanced vocal devices for the laryngectomees, and invention of antibiotic and anesthetic agents had led, by the middle of the 20th century, to the establishment of extended and radical surgical techniques as optional treatment for laryngeal cancer. In addition, the discovery of x-rays and radium introduced radiotherapy as an alternative in the treatment procedure for cancer of the larynx. Progress in the evolution of laryngological diagnosis and practice demanded efforts by many daring and courageous investigators and surgeons, contributing new ideas and techniques in the development of modern laryngology.