Investigations/S+S/Staging

Investigations

• Clinical examination/History

• Indirect laryngoscopy - mirror

• Nasendoscopy

• EUA + direct laryngoscopy

• Biopsy - definitive diagnosis

• Chest X-Ray

• CT/MRI

• PET-CT - Staging adv dis

• US lymph node assessment

Signs + symps

• Hoarseness- glottic

• Sore/irritated throat - SPG

• Odynophagia

• Otalgia - SPG

• Dysphagia - advanced dis

• Persistent cough

• WL

• Lump in throat

• Halitosis

• SOB - Stridor

Red flags symps

• Hoarseness > 6 weeks

• Dysphagia > 3 weeks

• Refer to ENT clinic

Staging T

Glottis:

• T1: limited/mobile

• T1a: One cord

• T1b: two cords

• T2: Extended SPG/SBG/impaired mobility

Supraglottis:

• T1: One subsite/mobile

• T2: > One subsite/Ext to glottis/Mobile

Subglottis:

• T1: Limited to SBG/mobile

• T2: Extends to VC/Mobile

T3: Cord fixation

T4:beyond larynx

Staging N

• N1: Ipsilateral single < 3 cm

• N2: Ipsilateral single > 3-6 cm, ipsilateral multiple < 6 cm Bilateral, contralateral < 6 cm

• N3: > 6 cm