Subglottic carcinoma

Subglottic malignancies are rare. They constitute about 1% of laryngeal cancer. Most of these malignancies are squamous cell carcinoma. In this article were describe various definitions concerning the borders of the subglottic region. A summary of pathophysiology and behavior of cancer in this location is presented. The incidence of primary subglottic carcinoma is low. The origin of most cancers in this area is the glottic cancer that extends into the subglottic region. The tumor tends to spread through lymphatic channels to the paraglottic and preglottic (delphian) nodes and secondary to the jugular chain. The delayed diagnosis is due to the lack of symptoms in the early stage of the disease and the hidden location of the tumor. The presenting symptoms are usually dyspnea and stridor. Direct laryngoscopy is essential for early detection of the tumor and the use of CT and MRI is advocated. Therapy is usually radical. Total laryngectomy and radiation therapy have both been advocated. Between 1995 and 2000, 126 patients with laryngeal squamous cell carcinoma were presented to our department. Our experience in diagnosing and treating subglottic cancer in 4 patients is hereby described. The latest literature on the subject is reviewed.