SACCULE (appendix of ventricle)   
• Diverticulum extending from ventricle 
• Between the vestibular fold, thyroarytenoid ...
 anterior & lateral to 
epiglottis
 Inferolaterally continuous 
with paraglottic space
PRE EPIGLOTTIC SPACE
OF BOYER
PARAGLOTTIC SPACE
 Adipose tissue, internal 
laryngeal nerve, laryngeal 
saccule
 Lat. – thyroid cartilage & 
thyrohyoid...
SITE SUBSITE
Supraglottis Suprahyoid epiglottis
Infrahyoid epiglottis
Aryepiglottic folds
Arytenoids
Ventricular band...
2.63% of all the body cancers in India
M:F = 10:1
40- 70 years
female incidence increasing
Black tobacco > light tobacco - aromatic amines and
tobacco specific nitrosamines & Tar content.
 Non filter cigarettes ...
 Alcohol formaldehyde
( ) vit. A synthesis
mucosal de-epithelisation
mucosa exposed
 Serum IgA levels in patients with
a...
OCCUPATIONAL EXPOSURE - asbestos, mustard gas, process of
isopropyl alcohol manufacturing, nickel refining, soot, tars, ac...
SUPRAGLOTTIC CANCER
site - epiglottis > false cords > aryepiglottic folds
Spread - vallecula, base of tongue & pyriform fo...
Symptoms: Early -Throat pain
Dysphagia
Ipsilateral otalgia
LN mass in the neck.
Late - Weight loss
Respiratory obstruction...
Supraglottic growths
GLOTTIC CANCER
Most common site - Free edge and upper surface of the vocal cords in its
anterior and middle third
spread- ...
Symptoms : Early - Hoarseness Late – Stridor
Laryngeal obstruction
(increased size, edema/ cord fixation)
Nodal mets – pra...
Glottic growths
SUBGLOTTIC CANCER
spread – anteriorly - anterior wall to the opposite side
downwards - trachea.
Upward spread – late
Mainl...
Symptom: Early - Stridor
Laryngeal obstruction
Late – Hoarseness
Nodal mets - prelaryngeal
pretracheal (delphian)
paratrac...
Subglottic growths
Broadening of the larynx
Loss of crepitation
Tenderness of larynx
Weight loss
Chronic cough; Hemoptysis
Dysphagia
Odynopha...
Hoarseness of voice
Have you heard a patient with hoarseness of voice beforet.mp4 - YouTube - Copy.mp4
THANK YOU ALL MY
FRIENDS FOR BEING
PATIENT AND LISTENING
ME
Happy
Independence
Day
Jai Hind !!!
Ca larynx - etio & types
Ca larynx - etio & types
Ca larynx - etio & types
Ca larynx - etio & types
Ca larynx - etio & types
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Ca larynx - etio & types

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Ca larynx - etio & types

  1. 1. SACCULE (appendix of ventricle)    • Diverticulum extending from ventricle  • Between the vestibular fold, thyroarytenoid & thyroid cartilage • Contains mucous glands , lubricates the vocal folds  CONUS ELASTICUS Elastic tissue layer extending from vocal ligaments to cricoid arch,  attaches to inner thyroid lamina & arytenoids 
  2. 2.  anterior & lateral to  epiglottis  Inferolaterally continuous  with paraglottic space PRE EPIGLOTTIC SPACE OF BOYER
  3. 3. PARAGLOTTIC SPACE  Adipose tissue, internal  laryngeal nerve, laryngeal  saccule  Lat. – thyroid cartilage &  thyrohyoid membrane  Superomed. – quadrangular  membrane  Inferomed.  - conus  elasticus  Superiorly continuous with  pre – epiglottic space
  4. 4. SITE SUBSITE Supraglottis Suprahyoid epiglottis Infrahyoid epiglottis Aryepiglottic folds Arytenoids Ventricular bands (false vocal cords) Glottis True vocal cords+ ant and post. Commissure +rima glottidis(slit) Subglottis Subglottic space upto lower border of cricoid
  5. 5. 2.63% of all the body cancers in India M:F = 10:1 40- 70 years female incidence increasing
  6. 6. Black tobacco > light tobacco - aromatic amines and tobacco specific nitrosamines & Tar content.  Non filter cigarettes > filter cigarettes - tar content  Smoking hand-rolled cigarettes > commercially manufactured cigarettes - 2.7* risk. Chewing tobacco or inhaling snuff - 50% in risk. Risk of developing ca larynx decreases with increasing time since cessation of smoking, indicating tobacco as a promoter and initiator in carcinogenesis. SMOKING
  7. 7.  Alcohol formaldehyde ( ) vit. A synthesis mucosal de-epithelisation mucosa exposed  Serum IgA levels in patients with alcoholic liver disease  Associated malnutrition 15* RISK
  8. 8. OCCUPATIONAL EXPOSURE - asbestos, mustard gas, process of isopropyl alcohol manufacturing, nickel refining, soot, tars, acid mists, beryllium and bischloromethyl ether & the glass wool production. GENETIC - Japanese and Russian VIRUSES - HSV, HPV, EBV ( EBV- specific IgA antibodies block IgG mediated tumor destruction). Previous RADIATION to head & neck Low SOCIOECONOMIC STATUS - smoking habits
  9. 9. SUPRAGLOTTIC CANCER site - epiglottis > false cords > aryepiglottic folds Spread - vallecula, base of tongue & pyriform fossa. Cancer of infrahyoid epiglottis & anterior ventricular band extend into pre-epiglottic space and penetrate the thyroid cartilage.
  10. 10. Symptoms: Early -Throat pain Dysphagia Ipsilateral otalgia LN mass in the neck. Late - Weight loss Respiratory obstruction Halitosis (tumor necrosis) Nodal mets - upper and middle jugular nodes. Bilateral mets (epiglottis)
  11. 11. Supraglottic growths
  12. 12. GLOTTIC CANCER Most common site - Free edge and upper surface of the vocal cords in its anterior and middle third spread- anteriorly - anterior commissure &opposite cord posteriorly - vocal process and arytenoids upward – ventricle & false cord downwards - subglottis
  13. 13. Symptoms : Early - Hoarseness Late – Stridor Laryngeal obstruction (increased size, edema/ cord fixation) Nodal mets – practically absent, if early stage
  14. 14. Glottic growths
  15. 15. SUBGLOTTIC CANCER spread – anteriorly - anterior wall to the opposite side downwards - trachea. Upward spread – late Mainly invade cricoid & thyroid cartilages Extralaryngeal spread characteristic Site - subglottis
  16. 16. Symptom: Early - Stridor Laryngeal obstruction Late – Hoarseness Nodal mets - prelaryngeal pretracheal (delphian) paratracheal lower jugular
  17. 17. Subglottic growths
  18. 18. Broadening of the larynx Loss of crepitation Tenderness of larynx Weight loss Chronic cough; Hemoptysis Dysphagia Odynophagia Ipsilateral otalgia Halitosis Mass in the neck HISTORY: “patient in cancer age group having persistent or gradually increasing hoarseness of voice for 3 weeks must have laryngeal examination to exclude cancer” Persistent hoarsenessDyspnea and stridor
  19. 19. Hoarseness of voice Have you heard a patient with hoarseness of voice beforet.mp4 - YouTube - Copy.mp4
  20. 20. THANK YOU ALL MY FRIENDS FOR BEING PATIENT AND LISTENING ME
  21. 21. Happy Independence Day Jai Hind !!!
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