Il Cancro Dell'Epiglottide

Abstract

A correct therapy of the epiglottis cancer is grounded on the exact knowledge of the following points: tumor site; ways of spreading; lymph node metastases. In regard to site, the epiglottis cancer may involve the laryngeal surface, the free edge, or the lingual surface. The ways of spreading are different, in relation to the primary site of the tumors. Those of the laryngeal surface remain long circumscribed when they affect the suprahyoid portion, whereas they tend to invade the pre-epiglottic space when the subhyoid portion is involved; those of the free edge spread along the aryepiglottic and pharyngoepiglottic plicae, those of the lingual surface more frequently to the valleculae and the base of the tongue. Lymph node metastases are more precocious and frequent in the tumors of the subhyoid portion of the laryngeal surface than in those of other sites; they are almost always bilateral. Therapy consists in the horizontal supraglottic partial laryngectomy in the cancers of the laryngeal surface and of the edge; the radiological treatment is indicated for the tumors involving the aryepiglottic and pharyngoepiglottic plicae and the base of the tongue. The bilateral intervention on the lymph nodes is always advised. Such therapeutical criteria are based on the experience of 30 cases of epiglottic cancer observed in the years 1951–1960 in the Otorhinolaryngological Clinic of the University of Milan.