[Otolaryngological cancer pain at the after-effects stage]

Ann Otolaryngol Chir Cervicofac. 2007 Oct:124 Suppl 1:S39-44. doi: 10.1016/s0003-438x(07)80009-0.
[Article in French]

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.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Humans
  • Laryngeal Neoplasms / complications*
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery
  • Otorhinolaryngologic Diseases / complications*
  • Pain / drug therapy
  • Pain / etiology*
  • Pharyngeal Neoplasms / complications*
  • Pharyngeal Neoplasms / radiotherapy
  • Pharyngeal Neoplasms / surgery
  • Postoperative Complications
  • Radiotherapy / adverse effects
  • Time Factors