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Chapter 44. Tumors of the Larynx

A 55-year-old patient presents with history of hoarseness for 6 months and on examination is found to have an ulcerative lesion extending from the right true vocal fold across the anterior commissure to the left vocal fold. He is recommended to obtain a CT scan to assess possible spread of disease to the thyroid cartilage. What structure facilitates this process?

A. Conus elasticus

B. Quadrangular membrane

C. Broyle ligament

D. Ventricle

E. Vocal ligament

A 78-year-old man presents with history of laryngeal cancer limited to the true vocal folds. He has had multiple prior resections endoscopically with his last one being about 5 years ago. He reports recently starting smoking again after undergoing a cervical spine fusion procedure. On examination, he has a suspicious lesion at the anterior commissure, which was biopsied and noted to be CIS. He is very interested in preserving his voice. What is the best treatment?

A. Observation and vocal cord stripping if he has progression

B. Radiation

C. Endoscopic surgery

D. Total laryngectomy

E. Laryngofissure with excision of lesion and keel placement

A 45-year-old man presents with 5-month history of worsening odynophagia and otalgia. He is noted on physical examination to have an ulcerated mass over the lingual epiglottis extending to the false vocal fold on the right. He is also noted to have some decreased mobility of his right vocal fold. On imaging he is noted to have invasion of the paraglottic space and bilateral enlarged lymph nodes with largest being 2.5 cm in size. What is the clinical stage for this patient?

A. T3N2c

B. T3N1

C. T2N1

D. T3N2b

E. T2N2c

A 67-year-old man presents with a 2-cm exophytic, ulcerating mass on the right false vocal fold. He has no evidence of enlarged lymph nodes on CT scan and on biopsy is reported to have verrucous carcinoma. What is the best treatment?

A. Observation

B. Radiation

C. Supraglottic laryngectomy with bilateral neck dissection

D. Total laryngectomy

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