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[Otolaryngological cancer pain at the after-effects stage].

Authors
  • Navez, M-L
Type
Published Article
Journal
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris
Publication Date
Oct 01, 2007
Volume
124 Suppl 1
Identifiers
PMID: 18047863
Source
Medline
License
Unknown

Abstract

The standards of pharyngolaryngeal tumor treatment have changed over the years in an attempt to prevent laryngeal mutilation (partial surgery, endoscopic surgery, sequential radiotherapy, and chemotherapy). Pain induced by these treatments is frequent and varies from one treatment to another. Chemoradiotherapy induces less pain but often more severe pain, since 20% of these situations are not controlled by strong opioids. Pain from mucositis, although nonspecific to otolaryngic cancer, is more frequent and more severe, and prevention and treatment remain poorly defined. Pain from postradiotherapeutic necrosis (mandibula, laryngeal cartilage, etc.) is less frequent, delayed, and extremely severe. Cervical and shoulder pain is present in more than one-third of patients and stems from a number of mechanisms (myofascial and articulatory). It is secondary to radiotherapy or surgery (XIth cranial nerve lesions during curage or flap reconstruction). Finally, pain coexists with disturbances of basic functions (speech, swallowing, etc.) and the disability generated by treatments. Management of pain, suffering, and the psychosocial impact is essential.

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