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6.6.6: 6. Clinical Evaluation- History and Examination

  • Page ID
    18365
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    Objectives

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

    Primary tumour

    • Site
      • Supraglottic (infra- vs suprahyoid, false cord, arytenoid, pre-epiglottic space, AE fold, epiglottic)
      • Glottic
      • Hypopharynx
      • Vallecula/BOT
      • Can the arytenoid(s) be spared?
    • T-stage
      • Vocal cord mobility
      • Cartilage invasion
      • Extralaryngeal extension
        • Through thyroid cartilage
        • Base of tongue
        • Pre-epiglottic space
    • Bulk
    • Arytenoid involvement
    • Laryngeal dysfunction: Stridor, voice, swallowing, aspiration

    Cervical nodes

    • Palpate the neck
    • Consider Ultrasound

    Synchronous Primary (upper aerodigestive tract, lungs)

    • Current/recent smokers have 5-10% second primary
    • History and office examination
    • Panendocopy
    • CXR / CT / PET