Common Tumours of the Larynx

This set of vocabulary flashcards covers the definitions, anatomical sites, classifications, epidemiology, and management strategies for common benign and malignant tumours of the larynx as presented by Dr. Kopdimma B.G.

Tumour

An abnormal mass of tissue with autonomous growth that persists even after the cessation of the initial stimuli and exceeds that of the normal tissue.

Benign Tumour

A type of growth that is very often encapsulated or does not infiltrate the basement membrane; the most common laryngeal example is the papilloma.

Malignant Tumour

An invasive tissue growth, with Squamous cell carcinoma (SCC) being the most common type found in the larynx.

Supraglottis

A site of the larynx containing the suprahyoid epiglottis, infrahyoid epiglottis, aryepiglottic folds, arytenoids, and ventricular bands (false vocal cords).

Glottis

A site of the larynx comprised of the true vocal cords (anterior and posterior) and the commissure.

Subglottis

The lower part of the larynx which contains no subsites.

Lymphatic drainage (Above vocal cords)

Matches the parallel superior laryngeal vessels and drains to the superior deep cervical nodes.

Lymphatic drainage (Below vocal cords)

Matches the parallel inferior laryngeal vessels and drains to the pre- or paratracheal nodes, then to the inferior deep cervical nodes.

Physiological Functions of the Larynx

Includes protection of the tracheo-bronchial tree (via cough reflex and cricopharyngeal sphincter), respiration, phonation, and increasing intra-abdominal pressure for straining or labour.

Squamous Cell Carcinoma (SCC)

The most common laryngeal malignancy, accounting for about $85\%$ of cases and approximately $1\%$ of all cancers.

Male to Female Gender Ratio (Nigeria)

The ratio of laryngeal cancer occurrence in Nigeria is recorded as $6:1$, compared to $4:1$ in some western countries.

Juvenile-onset recurrent respiratory papilloma (JORRP)

A benign laryngeal tumour occurring in younger age groups, often associated with HPV types $6$ and $11$.

HPV 6 and 11

The specific strains of Human Papillomavirus responsible for benign laryngeal papillomas.

Hot potato speech

A clinical systemic feature often associated with the presentation of malignant laryngeal tumours.

FB sensation

A feeling of a foreign body sensation stuck in the throat, which can be a symptom of both benign and malignant laryngeal tumours.

TNM Staging Minimum Criteria

$T = \text{Tumour site/size}$, $N = \text{Nodes size and mobility}$, and $M = \text{Metastasis}$, evaluated through endoscopy, biopsy/histology, physical examination, and imaging.

Primary Prevention

Preventative measures including vaccination for HPV and public awareness campaigns regarding the dangers of smoking and alcohol.

Secondary Prevention

Education for screening and endoscopy for patients with hoarseness lasting over $3/52$ (three weeks) to ensure early referral.

Surgical Options for Laryngeal Tumours

Options include extirpation during rigid direct laryngoscopy, tracheostomy, microdebrider power instruments, conservative laryngectomy, total laryngectomy, and neck dissection.