Neoplasms of the Larynx

Squamous Cell Carcinoma Prognosis

Fig. 4.87 Carcinoma of the vocal cord. This usually occurs in smokers. The indurated leukoplakia on this vocal cord (arrow) is a well-differentiated squamous cell carcinoma that has arisen as a result of chronic laryngitis with hyperkeratosis. The prognosis for vocal cord carcinoma with radiotherapy is excellent, with a cure rate of over 90% for early lesions. The voice returns to normal, as does the appearance of the vocal cord. Fig. 4.88 Supraglottic squamous cell carcinoma. Carcinoma of the larynx commonly involves the vocal cord (glottic carcinoma), but lesions may develop below the cord (subglottic) or above the cord (supraglot-tic). The ulcerated area of granulation tissue above the edematous vocal cord in this case is a squamous cell carcinoma.

Fig. 4.89 Subglottic squamous cell carcinoma. The prognosis for supra-glottic and subglottic carcinoma is worse than for glottic carcinoma, for hoarseness is delayed until the cord is involved and the greater vascularity and lymphatic drainage above and below the cord predisposes to earlier metastasis.

Supraglot InvolvementVocal Cord Granulation Tissue

Fig. 4.91 The laser beam for surgical excision. This may prove to be the technique of choice for certain lesions in the upper respiratory tract. In this case it is being used at microlaryngoscopy to excise an intubation granuloma (see Fig. 4.78). The laser is now widely used for the removal of tongue (see Fig. 4.31) and pharyngeal lesions, particularly hemangiomas and other vascular lesions. The laser also appears to have advantages for excision of juvenile papillomas, intubation granulomas, and possible laryngeal webs. Use of the operating microscope ensures precise excision with the laser beam, which causes considerably less tissue damage than cautery or diathermy.

Fig. 4.91 The laser beam for surgical excision. This may prove to be the technique of choice for certain lesions in the upper respiratory tract. In this case it is being used at microlaryngoscopy to excise an intubation granuloma (see Fig. 4.78). The laser is now widely used for the removal of tongue (see Fig. 4.31) and pharyngeal lesions, particularly hemangiomas and other vascular lesions. The laser also appears to have advantages for excision of juvenile papillomas, intubation granulomas, and possible laryngeal webs. Use of the operating microscope ensures precise excision with the laser beam, which causes considerably less tissue damage than cautery or diathermy.

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