Benign tumors of the oropharynx and laryngopharynx: causes, symptoms, diagnosis, treatment

In the area of the oropharynx and the laryngopharynx, tumors can sometimes develop from tissues that form the morphological basis of the organs of these anatomical formations: epithelium and connective tissue, for example, papillomas, epitheliomas, adenomas, fibromas, lipomas, chondromes, less often vascular tumors-angiomas, lymphomas.

[1], [2], [3], [4], [5]

Papillomas of the oropharynx and laryngopharynx

Papillomas develop most often at the level of the soft palate, on the palatine tonsils, less often on the epiglottis or one of the arytenoid cartilages. They can be combined with laryngeal papillomatosis. Papillomas of the pharynx have the appearance of blackberry berries, grayish-pink, often located on the stem emanating from the tip of the tongue. Tumors do not cause any anxiety, except for tumors of considerable size or, when detected by the patient himself, cause him to fear of having a tumor disease. Remove them in the usual way (scissors, cutting loop).

Adenomas of the oropharynx and laryngopharynx

Adenomas arise from the glandular apparatus and refer to "solid" homogeneous or cystic tumors. Less common are gliomas and myxomes. In the laryngeal part of the pharynx, these tumors most often occur on the lingual surface of the epiglottis and in the pear-shaped sinuses. The glandular tumors of the root of the tongue are cystic formations the size of a pea. Tumors of the dystopic salivary glands can reach the size of a walnut or a small apple. Such tumors cause significant difficulty in swallowing and must be removed.

[6], [7], [8], [9]

Vascular tumors of the oropharynx and larynx

Vascular tumors, which include angiomas, lymphomas, are most often associated with similar tumors of the oral cavity and are located on the root of the tongue or on the soft palate. They can be arterial, venous, mixed or have a cavernous structure. Angiomas of blood vessels differ in color from bright red (for example, polypoid telangiectasia of palatine tonsils) to cyanotic-purple (cavernous angioma). Tumors from the lymphatic vessels (lymphomas) usually have a dull yellowish color and are more dense than tumors consisting of blood vessels. They, unlike angiomas, do not undergo arthrosis, while tumors from the blood vessels often cause bleeding, which is an indication for their removal.

Treatment consists in preliminary introduction into these tumors of sclerosing substances with their subsequent diathermocoagulation. Usually, such tumors are the competence of specialists in surgical dentistry.

Connective-tissue tumors of the oropharynx and laryngopharynx

Connective tissue tissues are very diverse. Fibromas and lipomas are located on the mucous membrane; the first have a grayish-bluish color, the second - yellowish and can resemble lymphomas. Fibromas of the palatine tonsils come from the connective tissue layer. To the posterior wall of the pharynx there are osteomas, chondromas and neurinomas.

[10], [11], [12], [13]

Thyroid gland tumors

Tumors from the thyroid gland come from the non-infected embryonic thyroid-ligament canal and develop at the root of the tongue (the so-called lingual goiter) immediately in front of the epiglottis, reaching the size of a walnut or chicken egg. These tumors have a spherical shape, are located along the middle line in a dense connective tissue capsule and are covered with a normal mucosa, moving relative to the underlying layer, in which the enlarged veins sometimes pass. First, the tumor only causes a foreign body sensation in the lower part of the pharynx, but when it reaches a larger size, there are breathing disorders, up to asphyxia requiring an emergency tracheotomy. The tumor is detected with indirect laryngoscopy and palpation, in which either a fluctuating formation (cystic form) or a dense tumor (parenchymal or colloid form) is determined.

With a small tumor, it is removed transorally. With a tumor of considerable size, especially when it is richly vascularized and causes respiratory failure, a preliminary tracheotomy is performed and under the intubation anesthesia the tumor is removed trahnehioidally. The tumor is partially removed, since it can be in the singular and the total removal of it can lead to the development of postoperative myxedema. Before the operation, it is advisable to conduct a study with the fixation of radioactive iodine to determine the topography of the thyroid gland tissues.

Tumors of the thyroid gland

Tumors of the thyroid-geriatric space, which is bounded posteriorly by the lingual surface of the epiglottis, in front by the lining of the hypoglossal membrane and the sublingual-epiglottis ligament, are most often cystic in nature. In other cases they can consist of fibrous tissue or even have a mixed character. At the beginning of their development, these tumors cause mild breathing disorders, especially during physical exertion, but as they grow, breathing disorders become more significant, especially during sleep (snoring, apnea). With indirect laryngoscopy, a smooth-walled, rounded, normal mucosal tumor is defined in the indicated area, which displaces the epiglottis to the entrance to the larynx, deforms the cherpalodnortal fold, expanding it and smoothing the laryngopharyngeal furrow.

The tumor is removed through subhnoidal pharyngotomy and dissection of the thyrotilaginous membrane, after which the tumor of the stalk is accessible and easily excavated entirely.