## Most Common Site of Laryngeal Carcinoma **Key Point:** The glottic region (true vocal cords) accounts for approximately 60–70% of all laryngeal carcinomas, making it the most frequent site of origin. ### Anatomical Distribution | Site | Frequency | Clinical Features | |------|-----------|-------------------| | **Glottic (vocal cord)** | 60–70% | Early hoarseness; better prognosis (early detection) | | Supraglottic | 25–30% | Late presentation; dysphagia, neck mass | | Subglottic | 5–10% | Rare; poor prognosis (advanced at diagnosis) | | Anterior commissure | <5% | Difficult to treat; high recurrence | ### Why Glottic Carcinoma Presents Early 1. **Vocal cord involvement** → immediate dysphonia 2. **Hoarseness is an alarm symptom** → patients seek early medical attention 3. **Limited lymphatic drainage** → lower nodal involvement at presentation 4. **Better 5-year survival** (70–90%) compared to supraglottic (40–50%) **Clinical Pearl:** Hoarseness persisting >3 weeks in a smoker warrants laryngoscopy. Glottic tumours are caught early because voice change is an immediate functional symptom. **High-Yield:** Supraglottic carcinomas present late (with neck mass, dysphagia) because they do not impair phonation early; subglottic tumours are rare and have the worst prognosis due to advanced stage at diagnosis. [cite:Robbins 10e Ch 16]
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