Laryngeal carcinoma: our experience at Obafemi Awolowo University Teaching Hospital complex, Ile-Ife, Nigeria

Abstract

To determine the prevalent age, frequency, pattern ofpresentation, investigations and outcome of management of laryngeal carcinoma in our environment. 10 year retrospective study (January 1994 to December 2003). Teaching hospital. 13 patients with tissue diagnosis managed for laryngeal carcinoma. The age, sex, occupation, presentation, use of cigarettes and alcohol, investigations, tissue diagnosis, outcome of management and duration of follow up were extracted from hospital records and analysed. The age of patients ranged 38 to 88 years (median 69, male: female ratio=12:1). The histopathology was squamous cell carcinoma in all. Common symptoms included hoarseness of voice and breathlessness in all the patients, cough and weight loss in seven patients and otalgia in six. Only one patient indulged in alcohol while two were regular cigarette smokers. All the patients presented in stage IV with respiratory distress necessitating emergency tracheostomy in all. Seven patients had total laryngectomy plus post-operative radiotherapy while two patients had pharyngo-laryngectomy, thyroidectomy and radical neck dissection plus post-operative radiotherapy and thyroxine supplement. Post operative complications included pharyngocutaneous fistula in two patients, pharyngeal stenosis, stoma stenosis, and hypocalcaemia with hypothyroidism in one patient each. The fistulae were management conservatively. Prognosis was good despite late presentation. Laryngeal carcinoma occurs predominantly in males. Presentation is late with hoarseness of voice and breathlessness in our community. Soft tissue neck X-ray is a useful diagnostic tool. Scarcity of radiotherapy centres, ignorance, local taboos, poverty and poor recognition by general medical practitioners negatively affected management of the patients. Laryngeal carcinoma should be excluded when managing elderly patients for bronchial asthma.