Vocal Cord Fixation In Laryngeal Carcinoma

Abstract

Fixation of the vocal cord in glottic carcinoma is a poor prognostic sign. In a follow-up study of 134 patients with T₂N_oM_o glottic carcinomas, only 55 % of those with impaired mobility of the vocal cord survived 5 years, compared with 70% of those with normal mobility. In a separate study of 28 serially sectioned laryngectomy specimens, with a fixed vocal cord before surgery, the main cause of vocal cord fixation was invasion of the thyro-arytenoid muscle. The more extensive carcinomas invaded other laryng-eal structures, including the laryngeal framework. There was a very poor correlation between the pre-operative clinical assessment and the pathological findings. Over 50% of these cases were clinically underassessed, chiefly because of spread of the tumour outside the larynx. We have concluded that until better methods of clinical assessment are developed, fixation of the vocal cord in glottic carcinoma is a contraindication to conservation surgery.