The anatomic distribution of malignant and premalignant glottic lesions and its relations to smoking.
OBJECTIVE
To describe the anatomic location and distribution of glottic dysplasia and early glottic cancer.


METHODS
Case series with chart review.


METHODS
Tertiary care referral center.


METHODS
Review of 167 glottic dysplasia or carcinoma patients between 2008 and 2013. Lesions were described in terms of location and size, and a novel grid system was used to map out anatomic distribution.


RESULTS
Seventy-eight patients with dysplasia and 89 with early glottic carcinoma were included. One hundred twenty-eight were smokers and 39 nonsmokers. The medial aspect of the vocal fold was more involved than the superior aspect, 95% versus 71%, respectively (P < .001). The superior aspect was more involved in smokers, 77% versus 51% in nonsmokers (P = .0016). Using a grid system, the most involved area was the midpoint of the membranous vocal fold at the transition between the superior and medial aspects. Ninety-seven percent of the lesions occupied this specific area, with no difference between smokers and nonsmokers. The vocal process mucosa was involved in 48 patients. Exclusive vocal process involvement was limited to 2 cases. All other 46 patients demonstrated extensive disease, encompassing more than half of the vocal fold's length. Carcinomatous lesions tended to be larger relative to dysplastic lesions. Otherwise, all lesion types showed a similar pattern of distribution.


CONCLUSIONS
Premalignant and malignant glottic lesions tend to involve the medial aspect of the vocal fold and the midpoint of the membranous part in particular. In smokers, lesions tend to be larger on presentation and are more likely to involve the superior aspect.
Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel Shoffel@gmail.com.
Hagit
H
Shoffel-Havakuk
Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel.
Doron
D
Halperin
Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel.
Liron
L
Yosef
Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel.
Yaara
Y
Haimovich
Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel.
Yonatan
Y
Lahav
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology / Q000473:pathology*; D055815:Young Adult
anatomy; anterior commissure; cancer; dysplasia; glottic carcinoma; glottis; smoking; vocal process