Rodrigo Arrangoiz MS, MD, FACS, FSSO

The larynx plays a central role in coordinating the functions of the upper aerodigestive tract, including respiration, speech, and swallowing.
The larynx is the second most common site for squamous cell carcinoma in the head and neck, which is causally related to tobacco and alcohol exposure.
The larynx is divided into supraglottic, glottic, and subglottic regions.
These anatomic divisions are based on embryologic development and have important clinical implications.
Lymphatic drainage of the supraglottic larynx is very rich compared with the scanty lymphatic network in the submucosal plane of the true vocal cords.
The patterns of regional spread of laryngeal cancer therefore depend on the site of origin and the local extent of the primary tumor.
Each of the three regions of the larynx is divided into various sites.
The sites in the supraglottic region are the laryngeal surface of the epiglottis, the aryepiglottic folds, the arytenoids, the ventricular bands or false vocal cords, and the ventricles, which are potential spaces between the false and true vocal cords.
In the glottic larynx, the right and left vocal cords and anterior commissure represent the three designated sites.
The subglottic region is generally considered as one site and is divided into its right and left lateral walls.
Squamous cell carcinomas constitute more than 95% of primary malignant tumors of the larynx.
The remaining tumors are those arising from the minor salivary glands, neuroepithelial tumors, soft tissue tumors, and, rarely, the cartilaginous laryngeal framework.
In 2018, the American Cancer Society estimated that approximately 13,150 new cases of cancer of the larynx would be diagnosed in the United States, which represents 0.8% of all new cancers.
Death rate estimates vary, depending on the site and stage of the primary tumor.
Overall, 3,710 cause-specific deaths for cancer of the larynx were estimated for 2018 in the United States.
Worldwide, the incidence of laryngeal cancer varies in different countries. Southern Europe has by far the highest incidence of laryngeal cancer in men in the world.
The geographic variation in the incidence rates and anatomic site distribution may be a reflection of lifestyle and habits of the patient population in different parts of the world, as well as other environmental factors.