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Carcinomas of larynx and hypopharynx are the very common primary head and neck malignancies.Incidence is strongly related to age, and is rare before 40 years of age. The larynx and hypopharynx are closely integrated anatomically and functionally. Anatomically larynx is divided into the three sub divisions and certain potential spaces through which cancer tends to spread outside the site of its origin. The causal relationship between alcohol and tobacco intake, genetic predisposition, diet, and socioeconomic conditions in the development of squamous cell cancers of the head and neck applies as well to laryngeal and hypopharyngeal cancer. Site predilection for the origin of cancers of laryngeal cancers being Glottic carcinoma being 60 to 65%, Supraglottic carcinoma 30 to 35% and Subglottic carcinoma less than 5%. Site predilection for the origin of cancers of hypopharyngeal cancers being pyriform Sinus 70%, post cricoid region 15% and posterior pharyngeal wall 15%. Clinico-endoscopic evaluation can be undertaken with indirect laryngoscopy, fibreoptic laryngoscopy / telescopic laryngoscopy (70 hopkins) and direct laryngoscopy. Imaging (USG, CECT±CEMRI) plays a significant complementary role to clinical endoscopy in pretherapeutic staging of laryngeal and hypo pharyngeal malignancies. Determination of the precise extent of cancer spread within the larynx (T staging) is the single most critical factor guiding treatment decisions in patients with localised laryngeal cancer. In present study out of 25 patients of laryngeal and hypopharyngeal malignancies, 16 (64%) patients were treated by radiotherapy or concurrent chemoradiation, 4 (16%) patients were treated by total laryngectomy with neck dissection and 3 (12%) patient were treated by total laryngectomy with partial pharyngectomy with neck dissection and 2 (8%) patients were treated by total laryngectomy alone.

CLINICO-ENDOSCOPIC AND RADIOLOGICAL ASSESSMENT IN THE PRETHERAPEUTIC STAGING OF LARYNGEAL AND HYPOPHARYNGEAL MALIGNANCIES