Summary
Definition
History and exam
Key diagnostic factors
- age >40 years
- hoarseness
- dysphagia
- odynophagia (painful swallowing)
- cervical lymphadenopathy
- supraglottic or glottic mass
- lesional erythroplasia, ulceration, necrosis, or bleeding
- signs of airway obstruction
- hemodynamic instability
Other diagnostic factors
- sore throat
- otalgia
- dyspnea
- middle ear effusion
- stridor
- weight loss or cachexia
- general distress
- oral and pharyngeal masses or leukoplakia
- loss of laryngeal crepitus
- parotid and thyroid growths
- diminished breath sounds
Risk factors
- tobacco use >40 pack-years
- alcohol use >8 units/day
- GERD
- achlorhydria
- hx of radiation therapy
- FHx of laryngeal cancer
- black ethnicity
- male sex
- vocal fold dysplasia
- asbestos exposure
- Agent Orange exposure
- immunocompromised host
- human papillomavirus (HPV) exposure
- hx of respiratory papillomatosis
Diagnostic investigations
1st investigations to order
- neck CT with contrast
- chest CT with contrast
- FNA of neck mass
- flexible fiberoptic laryngoscopy
Investigations to consider
- rigid videostroboscopy
- rigid direct laryngoscopy
- laryngeal biopsy
- whole-body PET/CT scan
- fluorescence endoscopy
Treatment algorithm
Contributors
Authors VIEW ALL
Professor of Surgery
Yale Cancer Center
Yale School of Medicine
New Haven
CT
Disclosures
CS declares that he has no competing interests.
Head and Neck Fellow
Yale University
New Haven
CT
Disclosures
MP declares that he has no competing interests.
Dr Clarence Sasaki, and Dr Matthew Pierce would like to gratefully acknowledge Dr Scott V. Larson, Dr Hari Deshpande, Dr Elina Kari, and Dr Amy Chen, previous contributors to this topic. SVL, HD, EK, and AC declare that they have no competing interests.
Peer reviewers VIEW ALL
Director
Department of Surgical Sciences
Professor and Chairman
ENT Clinic
University of Udine
Udine
Italy
Disclosures
AF declares that he has no competing interests.
Assistant Professor
Department of Otolaryngology
Rush University Medical Center
Chicago
IL
Disclosures
SJC declares that he has no competing interests.
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