The anatomic distribution of malignant and premalignant glottic lesions and its relations to smoking

Hagit Shoffel-Havakuk, Doron Halperin, Liron Yosef, Yaara Haimovich, Yonatan Lahav

Research output: Contribution to journalArticlepeer-review


Objective. To describe the anatomic location and distribution of glottic dysplasia and early glottic cancer. Study Design. Case series with chart review. Setting. Tertiary care referral center. Subjects and Methods. Review of 167 glottic dysplasia or carcinoma patients between 2008 and 2013. Lesions were described in terms of location and size, and a novel grid system was used to map out anatomic distribution. Results. Seventy-eight patients with dysplasia and 89 with early glottic carcinoma were included. One hundred twentyeight were smokers and 39 nonsmokers. The medial aspect of the vocal fold was more involved than the superior aspect, 95% versus 71%, respectively (P <001). The superior aspect was more involved in smokers, 77% versus 51% in nonsmokers (P = .0016). Using a grid system, the most involved area was the midpoint of the membranous vocal fold at the transition between the superior and medial aspects. Ninety-seven percent of the lesions occupied this specific area, with no difference between smokers and nonsmokers. The vocal process mucosa was involved in 48 patients. Exclusive vocal process involvement was limited to 2 cases. All other 46 patients demonstrated extensive disease, encompassing more than half of the vocal fold's length. Carcinomatous lesions tended to be larger relative to dysplastic lesions. Otherwise, all lesion types showed a similar pattern of distribution. Conclusions. Premalignant and malignant glottic lesions tend to involve the medial aspect of the vocal fold and the midpoint of the membranous part in particular.

Original languageEnglish
Pages (from-to)678-683
Number of pages6
JournalOtolaryngology - Head and Neck Surgery
Issue number4
StatePublished - 7 Apr 2015
Externally publishedYes


  • anatomy
  • anterior commissure
  • cancer
  • dysplasia
  • glottic carcinoma
  • glottis
  • smoking
  • vocal process


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