Role of Imaging and Clinico-Endoscopic Assessment in the Upstaging and Management of Laryngeal Malignancies

Abstract

Carcinomas of larynx are the very common primary head and neck malignancies. Cancer of larynx accounts for 30 percent of all head and neck cancers. The American Cancer Society’s most recent estimates for laryngeal cancer in the United States for 2013 are, about 12,260 new cases are laryngeal cancer, being 9680 in men and 2580 in women. Laryngeal cancer has also a strong socioeconomic association, being twice as common in more deprived groups compared to the more affluent groups. Anatomically larynx is divided three sub divisions and certain potential spaces through which cancer tends to spread outside the site of its origin. The causal relationship between alcohol and tobacco intake, genetic predisposition, diet, and socioeconomic conditions in the development of squamous cell cancers of the head and neck applies as well to laryngeal cancer. Site predilection for the origin of cancers of laryngeal cancers being, glottic carcinoma 60 to 65%, supraglottic carcinoma 30 to 35% and subglottic carcinoma less than 5%. Clinico-endoscopic evaluation can be undertaken with indirect laryngoscopy, fibre optic laryngoscopy/telescopic laryngoscopy (70⁰hopkins) and direct laryngoscopy. Imaging (USG, CECT±CEMRI) plays a significant complementary role to clinical endoscopy in pretherapeutic staging of laryngeal malignancies. In present study, patients of laryngeal malignancy were treated by radiotherapy or concurrent chemoradiation, some by total laryngectomy with neck dissection and few by total laryngectomy with partial pharyngectomy along with neck dissection and further some patients were treated by total laryngectomy alone depending upon the best treatment options.

Keywords: Laryngeal carcinoma, clinico-endoscopic assessment, radiological imaging, pretherapeutic staging

Cite this Article

Rashad Rafiq Mattoo., Sajad Majid Qazi, Basharat Rashid et al. Role of Imaging and Clinico-Endoscopic Assessment in the Upstaging and Management of Laryngeal Malignancies. Research & Reviews: Journal of Surgery. 2016; 5(3): 1–16p.