## Laryngeal Carcinoma: Site Distribution **Key Point:** The glottic region (true vocal cords) is the most common site for laryngeal squamous cell carcinoma, accounting for approximately 60–70% of all cases. ### Why Glottic Region? 1. **Largest mucosal surface area** in the larynx 2. **Prolonged smoke and alcohol exposure** — direct contact with carcinogens 3. **Early symptom detection** — hoarseness prompts early presentation and diagnosis 4. **Better prognosis** — early-stage disease due to symptom awareness ### Comparison of Laryngeal Sites | Site | Incidence | Characteristics | Prognosis | | --- | --- | --- | --- | | **Glottic** | 60–70% | Early hoarseness, better 5-yr survival | Favorable (Stage I: 80–95%) | | **Supraglottic** | 25–30% | Late presentation, dysphagia, referred otalgia | Moderate (Stage I: 60–75%) | | **Subglottic** | 5–10% | Rare, late diagnosis, airway involvement | Poor (Stage I: 40–50%) | | **Anterior commissure** | Subset of glottic | High recurrence risk if involved | Guarded | **High-Yield:** Glottic carcinomas present early with hoarseness (even small tumours affect voice), leading to earlier detection and better overall survival compared to supraglottic and subglottic sites. **Clinical Pearl:** A patient with persistent hoarseness >3 weeks warrants laryngoscopy to exclude glottic malignancy — early detection dramatically improves outcomes. 
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