Diseases Of The Nose Throat And Ear

CHAPTER 25
TUMOURS OF THE PHARYNX AND TONGUE

NON-MALIGNANT TUMOURS

Simple tumours are not commonly seen in the pharynx. Papillomata may be
found attached to the uvula, the tonsil, the margins of the soft palate or the
palatine arches. They are pedunculated. Fibromata are less common. They
also are pedunculated and may attain a larger size. Angiomata, which may be
cavernous or capillary in type, are often associated with larger angiomata of
the face and neck.

SYMPTOMS. Simple tumours do not usually give rise to symptoms, and may
be noticed by the patient or by the doctor during routine inspection. Should
the tumour be large it will cause a feeling of a lump in the throat and may
cause some dysphagia.

TREATMENT. It is probably always wise to remove the tumour however simple
it may appear clinically in order to avoid overlooking an early malignant
growth. The tumours should always be examined histologically. Pedunculated
tumours are easily removed with scissors, but small sessile growths may
require destruction with diathermy. Angiomata are less easily dealt with.

PRE-MALIGNANT TUMOURS

Leucoplakia may appear as a white patch on the tongue or the buccal mucosa
where it may be mistaken for lichen planus. It is thought to follow heavy pipe
or cigar smoking or the irritation of carious teeth, and it is regarded as
potentially malignant. Biopsy should always be performed especially if the
patch loses its whiteness to become red and velvety. Dental hygiene should
have attention and* smoking should be forbidden. The patch may be removed
by stripping or it may require excision or cauterization. The patient must be
followed up regularly. A speckled leucoplakia or an erythroplakia is very
liable to malignant change.

Parapharyngeal tumours, such as neurilemma, chemodectoma, reticulo-
sarcoma and fibrosarcoma, may lie lateral to the walls of the pharynx which
are bulged inwards by the tumour. The symptoms are of a feeling of fullness
in the mouth, a swelling of the neck, muffling of the voice if the soft palate is
involved and pain which radiates to the ear or along the lower jaw. The
diagnosis is confirmed by biopsy, and treatment is by radiotherapy combined
with surgical excision where this is possible.

MALIGNANT TUMOURS

Tumours of the Tongue and Mouth. The tongue must be examined routinely in
every patient with a complaint of a swelling in the throat or the neck, and to

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