A 60-year-old male with a T3N0M0 supraglottic squamous cell carcinoma (involving the epiglottis and pre-epiglottic space, cord mobile) is being counselled about surgical options. The appropriate voice-preserving surgical option is:

• A Supraglottic laryngectomy (horizontal partial laryngectomy) ✓
• B Total laryngectomy
• C Cordectomy
• D Hemilaryngectomy (vertical partial laryngectomy)

Explanation

Supraglottic laryngectomy removes the epiglottis, pre-epiglottic space, the aryepiglottic folds, and the false cords down to the laryngeal ventricle, preserving the true vocal cords and thus voice. It is the standard organ-preserving surgery for selected T2–T3 supraglottic carcinomas with mobile cords, adequate pulmonary reserve, and no glottic or subglottic extension. Hemilaryngectomy (vertical) is for glottic cancers. Cordectomy is for T1a/T1b glottic cancers.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.