## Anatomical Sites of Laryngeal Carcinoma **Key Point:** The glottis (true vocal cords) is the most common site of laryngeal carcinoma, accounting for 60–75% of all cases. ### Laryngeal Anatomy and Cancer Distribution The larynx is divided into three functional regions: | Laryngeal Region | Frequency of Cancer | Clinical Features | Prognosis | | --- | --- | --- | --- | | **Glottis (vocal cords)** | 60–75% | Early hoarseness; detected early | Best (Stage I: 85–95% 5-yr survival) | | **Supraglottis** | 25–40% | Late presentation; neck nodes common | Intermediate (worse than glottic) | | **Subglottis** | <5% | Rare; late presentation | Poorest (advanced at diagnosis) | | **Anterior commissure** | Variable (subset of glottic) | Difficult to treat; high recurrence | Worse than lateral cord tumors | ### Why Glottis is Most Common 1. **Largest mucosal surface area** in the larynx 2. **Direct exposure to carcinogens** (tobacco smoke, alcohol vapors) 3. **Squamous epithelium** of the vocal cord is highly susceptible to malignant transformation 4. **Lymphatic drainage** of the glottis is sparse, delaying nodal spread and allowing early detection **High-Yield:** Glottic cancers present early with hoarseness (because any mass on the vocal cord affects phonation), leading to earlier diagnosis and better prognosis compared to supraglottic or subglottic sites. ### Clinical Pearl Supraglottic cancers often present late because the supraglottis is less sensitive to mass effect on voice. Patients may have dysphagia, odynophagia, or neck nodes before noticing voice change. Subglottic cancers are rare but have the worst prognosis due to late presentation and proximity to the trachea. **Mnemonic:** **GlottIS is Most Common** — The **glottis** (true vocal cords) is the **most** frequent site because it has the **largest surface area** and **sparse lymphatics** (early detection = better survival).
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.