Key Points Early glottic cancer commonly presents as dysphonia associated with a white or red lesion of the vocal cord. Laryngeal leukoplakia is defined as a white lesion of mucosa that, based on its clinical features, cannot be assigned a…
Key Points Squamous cell carcinoma (SCC) accounts for 85% to 95% of malignant laryngeal tumors. Tobacco and alcohol are the two most important risk factors for the development of laryngeal SCC. In the United States, laryngeal SCC occurs in the…
Key Points Computed tomography (CT) and magnetic resonance (MR) imaging have become the procedures of choice for defining mass lesions and traumatic abnormalities. They supplement the findings at laryngoscopy when additional diagnostic information is required to plan treatment. Appreciation of…
Key Points To obtain the best outcome for the patient, perform pharyngoesophageal reconstruction as part of a knowledgeable multidisciplinary team. Hypopharyngeal defects are associated with the highest surgical complication rates in the head and neck. Careful monitoring of thyroid-stimulating hormone…
Key Points Advanced hypopharyngeal cancer is treated in a multimodality approach, either surgery followed by radiation with or without chemotherapy or with definitive chemoradiation. Induction larynx-preserving strategies should incorporate assessment of response to induction (bioselection). Postoperative chemoradiation with cisplatin is…
Key Points Patients with hypopharyngeal carcinoma have the worst prognosis when compared with other subsites of head and neck cancer. Hypopharyngeal carcinoma tends to have significant submucosal extent that can be hard to appreciate clinically and radiographically. Organ-preservation therapy for…
Key Points An esophagogram, sometimes called a barium swallow, should be used to evaluate pharyngeal mucosa, whereas a modified barium swallow should be used to assess deglutition. Positron emission tomography–computed tomography (PET-CT) has become an essential modality for the staging,…
Key Points Understanding normal swallow physiology and pathophysiology is essential in the evaluation and management of dysphagia in patients with head and neck cancer. Evaluation of dysphagia in patients with head and neck cancer requires comprehensive assessment using clinical and…
Key Points Oropharyngeal reconstruction is complex, but an organized systematic approach using the reconstructive ladder aids the surgeon in the decision-making process. The simplest reconstruction that results in the highest level of function should be chosen. The size and location…
Key Points The four primary subsites of the oropharynx are the palatine tonsil, base of tongue, soft palate, and posterior pharyngeal wall. Transoral laser microsurgery uses a bivalved laryngoscope or mouth gag, operating microscope, and mounted or handheld carbon-dioxide laser…