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6. Clinical Evaluation: History and Examination

  • Page ID
    18389
  • Objectives

    • Select appropriate surgery
    • Avoid unnecessary surgery
    • Avoid embarking on surgery that is beyond the scope of a surgeon

    Primary tumour

    • Site
      • Hypopharynx (subsite: lateral, medial pyriform, postcricoid)
      • Supraglottis
      • Glottis
      • Vallecula/BOT
      • Distant extent (may require flap reconstruction, oesophagectomy)
    • T-stage
      • Vocal cord mobility
      • Cartilage invasion
      • Extension to oropharynx, oesophagus
    • Mobility related to
      • Prevertebral tissues
      • Thyroid cartilage
    • Laryngeal dysfunction: Stridor, voice, swallowing, aspiration

    Cervical nodes

    • Palpate the neck
    • Consider Ultrasound

    Synchronous Primary (upper aerodigestive tract, lungs)

    • Upper aerodigestive tract, oesophagus, lungs
    • History and office examination
    • Panendocopy
    • CXR / CT / PET