THE LIMITS OF SURGERY to eradicate potential areas of lymphatic spread from carcinoma of the subglottic larynx and lesions of the pyriform sinus apex have been of great concern to laryngologists in planning the most likely cure of carcinomas arising in these areas.
Carcinoma of the larynx behaves in widely differing manners in its primary and metastatic sites. The two areas mentioned above certainly can be encompassed more accurately when the extent of the tumor is known by an exacting direct laryngoscopy or hypopharyngoscopy, by laryngograms or tomograms.
The areas of spread present another problem in that the lateral neck may not be the principal area of spread; therefore, when carcinoma arises primarily or extends to the subglottic area from a cordal lesion, immediate attention must be given to the thyroid gland and the paratracheal and recurrent laryngeal chair of lymph nodes because subclinical metastasis may go unnoticed, concealed either
Harris HH, Butler E. Surgical Limits in Cancer. Arch Otolaryngol. 1968;87(5):490–493. doi:10.1001/archotol.1968.00760060492009
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