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A 10 hour surgery to treat larynx cancer

Mr. N.T.P. was diagnosed with larynx cancer, which had expanded to the base of his tongue and a lymph node. Led by Dr. Nguyen Quang Dai, Head of Otolaryngology, specialists at FV Hospital  removed the larynx and the base of the tongue and then used microsurgery to reconstruct his tongue using a radial forearm flap graft from the patient. The surgery wrapped up successfully after 10 hours.

Dr Nguyen Quang Dai (seated) performs the surgery at FV on April 11, 2017.

Mr. N.T.P. was born in 1967 and resides in Bac Lieu province. Prior to being admitted to FVH, he’d experienced a vocal disorder and a sore throat for three months, then cervical lymph nodes for one month, when his health deteriorated remarkably. Upon examining Mr N.T.P., Dr Dai discovered that he had a huge tumour at the epiglottis and the base of the tongue. The patient was diagnosed with stage IV larynx cancer.

Mr P. was admitted to FV Hospital on 10 April 2017 to prepare for his surgery the following day. After 10 hours, the surgical team, lead by Dr Dai, succeeded in removing his larynx and the base of the tongue (including the tumour), as well as the metastasised nodes on both sides using an ultrasound scalpel. The patient’s tongue was reconstructed with a radial forearm graft using vascular microsurgical technique.

Fortunately, the marginal lymph nodes were identified as non-cancerous by anatomists, but Dr Dai identified it as a difficult case. The tumour was extremely large, measuring 10 cm in diameter, which made the removal process very complex to perform.

Dr Dai estimated that, post-surgery, Mr P. must remain hospitalised for two weeks. During the recovery procedure, he has to practice swallowing under instruction of an experienced physiotherapist. Moving forwards, he will practice vocal communication with support of an electrolarynx.

“As a doctor, my responsibilities are not only bound to saving a patient’s life, but also to enhancing their living standards,” shares Dr Dai.

Dr Dai asserts that larynx cancer is one of the most common diseases in Vietnam. It usually occurs in male patients after the age of 40 and is typically caused by smoking and drinking alcohol. Chronic laryngitis can also be a precursor to larynx cancer. Patients often have symptoms such as hoarseness, difficulty breathing, and lymph nodes.

In treatment, the top priority is to remove the entire tumour, followed by the preservation or reconstruction of the throat and laryngeal function. To prevent illness, it’s essential that the patient quit smoking and only consume alcohol in moderation.

Anyone with the above symptoms should seek medical care. When cancer is detected and treated early, there is a much higher chance that the patient will recover.