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
- history of radiation therapy
- family history of laryngeal cancer
- black ethnicity
- male sex
- vocal fold dysplasia
- asbestos exposure
- Agent Orange exposure
- immunocompromised host
- human papillomavirus (HPV) exposure
- history of respiratory papillomatosis
Diagnostic investigations
1st investigations to order
- neck CT with contrast
- chest CT with contrast
- fine needle aspiration 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
Professor of Surgery
Yale Cancer Center
Yale School of Medicine
New Haven
CT
Disclosures
CS declares that he has no competing interests.
Otolaryngologist
Otolaryngology, Head and Neck Division
MedStar Washington Hospital Center
Georgetown University
Washington
DC
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.
Disclosures
SVL, HD, EK, and AC declare that they have no competing interests.
Peer reviewers
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.
Use of this content is subject to our disclaimer