Supraglottic Squamous Cell Carcinoma
Because of voice saving procedures and the indications for supraglottic laryngectomy as opposed to total laryngectomy it is important to evaluate the presence of transglottic spread (crossing the laryngeal ventricle). Tumor that extends to or below the laryngeal ventricle to the glottis usually requires a total laryngectomy. Also, if there is cartilaginous, postcricoid, or anterior commissure invasion a voice saving supraglottic laryngectomy cannot be performed.
Unfortunately, abundant lymphatics in the supraglottic and hypopharynx
lead to very early lymph node metastasis.
T - Staging for Supraglottic Cancer
T1: Limited to one sub site. Normal cord mobility.
T2: More than one sub site with normal cord mobility.
T3: Cord fixation and/or invasion of post cricoid area, piriform sinus, preepiglottic tissues.
T4: Invasion through thyroid cartilage and/or extension to tissues beyond larynx.
(Sub sites: false cords, arytenoids, suprahyoid, epiglottis, infrahyoid epiglottis, area epiglottic folds).