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The anterior commissure in glottic carcinoma
Author(s) -
Sessions Donald G.,
Ogura Joseph H.,
Fried Marvin P.
Publication year - 1975
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-197510000-00002
Subject(s) - anterior commissure , glottis , medicine , commissure , laryngectomy , posterior commissure , larynx , arytenoid cartilage , stage (stratigraphy) , lymphatic system , anatomy , surgery , pathology , biology , psychiatry , paleontology , nucleus
The laryngeal anterior commissure is a specific anatomic area of the glottis which is often involved by cancer. Of 586 patients with glottic cancer, five (1 percent) had pure anterior commissure lesions and 175 (25 percent) had vocal cord tumors secondarily involving the anterior commissure. One of three of these anterior commissure tumors also had subglottic extension. Despite the presence of blood vessels and lymphatics in the anterior commissure, metastasis to regional lymph nodes in rare (8 percent). Patients with Stage 1 and 2 lesions were treated by hemilaryngectomy with satisfactory results (45/61 — 74 percent). Only three patients had local recurrence after hemilaryngectomy. Patients with bilateral cord‐anterior commissure lesions had the poorest survival and highest recurrence rate, even after total laryngectomy. Subglottic extension of these anterior commissure tumors did not correlate with survival. Survival and recurrence rates were conversely proportional to the stage of the tumor at presentation. Although the anterior commissure is a theoretical site for cancer breakthrough and lymphatic spread, its apparent significance lies in the fact that its involvement by glottic primaries represents only increasing tumor size and thus an advanced stage of disease.