Carcinoma Larynx | Medical Science Optional Notes for UPSC PDF Download

Clinical Anatomy/Clinical features

Etiology

Causes:

• Smoking
• Alcohol consumption
• Previous exposure to neck irradiation
• Genetic factors
• Occupational exposure to asbestos, mustard gas, and petroleum products

TNM Staging System for Laryngeal Cancer:

• Tumor (T)
• Node (N)
• Metastasis (M)

Management of Carcinoma of Larynx

Supraglottis

• T1: Tumor confined to one specific area of the supraglottis, with normal vocal fold mobility.
• T2: Tumor spreads to more than one area of the supraglottis, maintaining normal vocal fold mobility.
• T3: Tumor is confined to the larynx with vocal fold fixation or invades specific areas like the postcricoid region, medial wall of piriform sinus, or pre-epiglottic tissues.
• T4: Tumor invades through cartilage and/or extends beyond the larynx, reaching areas such as the oropharynx or soft tissues of the neck.

Glottis

• T1: Tumor limited to vocal fold(s) with normal mobility, potentially involving anterior or posterior commissures.
  • T1a: Tumor confined to one vocal fold.
  • T1b: Tumor involves both vocal folds.
• T2: Tumor extends to the supraglottis and/or subglottis, or there is impaired vocal fold mobility.
• T3: Tumor is limited to the larynx with vocal fold fixation.
• T4: Tumor invades through the thyroid cartilage and/or extends to other tissues beyond the larynx, like the oropharynx or soft tissues of the neck.

Subglottis

• T1: Tumor limited to the subglottis.
• T2: Tumor extends to vocal fold(s) with normal or impaired mobility.
• T3: Tumor is limited to the larynx with vocal fold fixation.
• T4: Tumor invades through the thyroid cartilage and/or extends to other tissues beyond the larynx, such as the oropharynx or soft tissues of the neck.

Lymph Node Involvement

• N0: No regional lymph node metastases.
• N1: Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest diameter.
• N2: Metastasis in a single ipsilateral lymph node more than 3 cm, in multiple ipsilateral nodes, or in bilateral or contralateral nodes.

Distant Metastases

• M0: No distant metastases.
• M1: Presence of distant metastases other than those defined in the previous categories.

Investigations

• Indirect Laryngoscopy-Vocal cord mobility, extent of disease 
• Direct Laryngoscopy-Hidden areas of larynx (infrahyoid epiglottis, anterior commissure, subglottis, ventricle)

Treatment

Vocal Rehabilitation