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History Small lesion + long history slowly growing lesion Massive cancer + short history Aggressive lesion poor outlook
Cancer can coexists or supervene in leucoplakia, chronic laryngitis & TB Leucoplakia Chronic laryngitis
Vocal Cord Leukoplakia : This is a condition caused by chronic irritation which results in abnormal growth of the top layer of the skin lining the vocal cords.It is often seen in smokers and is considered a pre-cancerous condition.
CXR for metastasis, other disorders and as part of assessment of physical status
Larynx to delineate the extent of the tumour
X-ray CT scan MRI
X-ray Supraglottic tumour Tomography AP Lateral
Axial CT shows loss of pre-epiglottic fat by carcinomatous infiltrarion CT scan
Axial CT scan showing a soft tissue mass with several punctuate calcifications (Chondrosarcoma) CT scan
Epiglotic tumor （ laryngeal Ca. supraglotic type ） MRI
MRI Axial T1 image showing large supraglottic Ca extending to retropharyngeal space Abutting the Rt. carotid artery (curved open arrow) Destruction of the Rt. thyroid ala (short open arrow) Destruction of the Rt. arytenoid (short solid arrow)
MRI Sagittal T2 image of supraglottic Ca Extension involves the epiglottis :E Loss of normal pr-epiglottic fat plane: solid arrows Tongue base involvement : open arrow
The surgical specimen 1 year after surgery cordectomy
To expose the endolarynx for a vertical hemilaryngectomy, the thyroid cartilage has been slit in the midline from the thyroid notch to the cricothyroid membrane. The left vocal cord carcinoma is visible Laryngofissure or thyrotomy