Treatment modality and prognosis as a function of topography and clinical staging in laryngeal carcinoma

Treatment modality and prognosis in laryngeal cancer depends on topography and clinical staging. While conservation surgery is indicated in early supraglottic and glottic cases, total removal of larynx is the choice in subglottic and late supraglottic and glottic tumours. Total laryngectomy is also indicated in failures after conservation operations and D.X.R. We use deep X-ray therapy as a post-operative supplement in advanced cases where we remove larynx as well as some adjoining infiltrated area such as pharynx, tongue base, etc. D.X.R. is also indicated for palliation. As regards prognosis, it is best in early clinical stage-1 and clinical stage-2 tumours, specially in glottic area. Advanced cases where one has to remove extensively do not fare so well. Same is true for cases who require neck dissection

Combined rhino-cranial approach for rhino-cerebral disease

For extensive rhino-cerebral disease small window craniotomy should be avoided for removal of cerebral pathology, a wide-field exposure is essential. In our view lateral rhinotomy along with frontal craniotomy is the choice. While nose and fronto-ethmoid complex are cleared through lateral rhinotomy, anterior cranial fossa is cleaned through frontal craniotomy. Three illustrative cases are described