Tumors of the Larynx and Hypopharynx

Abstract

The larynx is one of most critical organ in the human body responsible for voice production. The larynx is subdivided into supraglottis, glottis, and subglottis. The tumor from each subsite has different biological behavior and has different pattern of spread. The supraglottic tumor has higher tendency to have lymphatic spread compared to glottis tumor. Treatment algorithm for laryngeal cancer has changed significantly with majority of tumors being treated by nonsurgical organ preservation approach. Early laryngeal lesions are managed either by radiotherapy or by endoscopic laser surgery. The minimally invasive surgery is beyond the scope of this book. The moderately advanced tumors are managed by concurrent chemoradiotherapy in majority of cases. The conventional total laryngectomy (TL) can be offered to this group in select cases. The very advanced tumors require TL and voice rehabilitation with tracheoesophageal prosthesis (TEP). Open conservative laryngeal procedures have become almost obsolete with the advent of endoscopic laser procedures and concurrent chemoradiotherapy regimens. Near total laryngectomy (NTL) is almost like total laryngectomy but voice quality is inferior to TEP and majority of clinicians prefer TL with TEP over NTL.