There are three main parts of the larynx:

Supraglottis: The upper part of the larynx

above the vocal cords, including theepiglottis.
Glottis: The middle part of the larynx where
the vocal cords are located.
Subglottis: The lower part of the larynx
between the vocal cords and thetrachea
(windpipe).

symptoms of carcinoma
larynx
A sore throat or cough that does not
go away.
Trouble or pain when swallowing.
Ear pain.
A lump in the neck or throat.
A change or hoarseness in the voice.

 Patients with advanced glottic

cancers will present with symptoms
similar to patients with early glottic
cancers.
As listed earlier these include
hoarseness or a change in the quality
of voice, odynophagia, halitosis or
otalgia.

 Not suprisingly the more ominous

symptoms, such as hemoptysis,
dysphagia, airway compromise and
neck mass are more common in
advanced stage disease.

 Additionally, the supraglottic and

subglottic lesions tend to be less
symptomatic and their insidious
growth results in a high percent of
patients presenting with advanced
stage disease

 Extensive spread into the soft tissues

of the neck, involvement of the
overlying skin, regional lymph node
metastases which are fixed or limited
in vertical mobility, and bulky
disease low in the neck all suggest a
poor prognosis.

Pathophysiology of Laryngeal
Cancer
Limitation of true vocal cord mobility
correlates with a worsening
prognosis, especially if the lesion
displays an invasive pattern of
growth rather than an exophytic or
verrucous one.

 Kirchner described two types of carcinomatous

involvement of the anterior commissure:
early lesions that are not invasive and confined
to the level of the glottis, and those lesions that
invade aggressively and spread superiorly to
involve the base of the epiglottis.
The latter tend to advance within the cancellous
framework of the thyroid cartilage deep to
normal appearing soft tissue and imply a poorer
prognosis

 Approximately of early glottic

cancer extends to the anterior
commissure. Approximately 1/5 of
early glottic cancer extends 5 mm or
more below the level of the true
vocal cords. Likewise, 1/5 extends to
involve the supraglottic region.

 Early glottic cancer infrequently

metastasizes, and when it does, it is
almost always to the ipsilateral neck.
Lesions limited to the true vocal
cords (e.g., T1 and T2) demonstrate
a 5% incidence of cervical
metastasis, while this figure jumps to
30-40% for T3 lesions.

 Approximately 95% of glottic

neoplasms are squamous cell
carcinoma. Tumor spread is usually
superficial and well visualized. Skip
lesions, like those seen in the
hypopharynx, are rare.