The subglottis has a rich network of lymphatics that crosses the midline. This explains the clinical behaviour of subglottic carcinoma compared to glottic carcinoma in terms of:

• A Earlier hoarseness due to direct cord involvement
• B Earlier bilateral and paratracheal lymph node involvement ✓
• C Better prognosis due to limited vascularity
• D Lower rate of local recurrence after partial laryngectomy

Explanation

The subglottis is rich in lymphatics that drain bilaterally to paratracheal, pretracheal (Delphian node), and anterior mediastinal nodes, in contrast to the glottis which has sparse lymphatics and thus a low rate of nodal metastasis. Subglottic carcinomas are therefore more likely to present with bilateral or contralateral nodal involvement and carry a worse prognosis. They also spread into the trachea and thyroid gland early.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.