It is unfortunately true that ordinarily carcinoma of the larynx is not discovered until nothing but total laryngectomy offers the patient a chance for existence. One of the reasons for this is the fact that the diagnosis of the affection is often difficult and may be impossible for even an expert. Another cause for the lateness of recognition of the disease is the slight regard usually paid by the patients to the persistent hoarseness that may precede the graver manifestations for years as the only symptom. A third and avoidable reason for the unrecognized advance of malignant laryngeal tumors is the widespread indifference to the acquirement of even moderate skill in laryngoscopy shown by a great part of the profession. Many physicians treat patients with chronic hoarseness by general means and do not even inspect the larynx.
FREER OT. THE DIAGNOSIS OF CARCINOMA OF THE LARYNX.. JAMA. 1903;XL(6):371-375. doi:10.1001/jama.1903.92490060025002d