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