الفهرس 
introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Laryngeal cancer affects men 4 times more frequently than women in the US. In other countries, men are affected up to 10 times more frequently than women. Squamous cell cancer is the most common type of glottic tumor and tends to arise in the anterior portion of the glottis, usually on the free margin of the vocal fold. Persistent hoarseness is the usual presenting symptom of glottic carcinoma. Small vocal cord lesions can result in significant hoarseness and patients with hoarseness often present at early stages. Early stage glottic cancers (i.e., T1 and T2,) are managed with a single modality, such as radiation, endoscopic excision, or conservation laryngeal surgery. Moderately advanced lesions (i.e., T3) may be treated with induction chemotherapy. In responders, radiation follows chemotherapy. Surgery follows chemotherapy in patients who do not respond. Surgical options include conservation laryngeal surgery or total laryngectomy, depending on the extent of the disease. Invasive tumors (i.e., T4) usually are managed with multiple modality treatment; often, a total laryngectomy is performed with ipsilateral neck dissection. Radiation therapy is performed postoperatively. Radiation is the primary nonsurgical treatment for early-stage glottic tumors (i.e., T1, T2). Advantages of radiotherapy include the avoidance of surgery and the subsequent hospitalization and a superior voice outcome. A useful voice is preserved in 80-95% of patients who were treated with radiation for an early glottic tumor. Of these patients, 80-90% is reported to have good-to-excellent voice quality.