Laryngeal carcinoma

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Laryngeal carcinoma is the commonest head and neck carcinoma. Patients with a persistantly hoarse voice, especially smokers, need to be investigated for the possibility of laryngeal carcinoma.

Contents

Anatomical definition

The larynx is divided into three regions for classification.

Supraglottis

This comprises of the larynx superior to the apex of the ventricle. It includes the laryngeal ventricle, vestibular folds, aretynoids, aryepiglottic folds and the epiglottis.

Glottis

This comprises the vocal cords and the anterior and posterior commisures of the larynx. It extends from the apex of the ventricle to 1 cm below.

Subglottis

This extends from the inferior border of the glottis to the lower boarder of the cricoid cartilage.

Aetiology

  • Commonest head and neck cancer in UK
  • Represents 1% of all maligancies in UK
  • More common in India and Malaysia
  • Male: female ratio 5:1
  • Incidence increases with age, peak age of presentation is 60-70
  • By far, biggest risk factor is smoking
  • In smokers only, alcohol intake is a risk factor

Pathology

Most cases are sqaumous cell carcinoma. Verrucous carcinoma a well differentiated varient of well-differentiated squamous cell carcinoma. Rare types of laryngeal carcinoma include adenocarcinoma, adenoid cystic carcinoma, fibrosarcoma, chondrosarcoma and lymphoma.

Clinical features

Investigations

Staging

Management