General Information

The larynx, or voice box, is a complex anatomic structure located below the oropharynx and above the trachea. Most of it lies just behind the Adam's apple. The hypopharynx lies on each side of the larynx and behind it.


It is divided into three distinct and important subsites:

The Glottis consists of the two "true" vocal cords, these narrow fibrous bands vibrate to produce sounds which are turned into speech by the muscles of the tongue, mouth and lips



The Supraglottic larynx is a larger area above the vocal cords which extends up to the base of the tongue. Structures within the supraglottic larynx include the false cords, ventricles, aryepiglottic folds, the arytenoids and the epiglottis (a flap that helps prevent food from going into the lungs when swallowing). The structures at the top of the supraglottis separate the air and food passages



The Subglottis is the area between the vocal cords and the top of the windpipe or trachea

Nearly all cancers arise from the lining of the larynx and are squamous cell carcinomas, but they differ widely in their behavior depending on their site of origin.

Cancers of the glottis or true vocal cords tend to be low grade tumours which grow slowly and spread late. Cancers of the supraglottic larynx region tend to be higher grade tumours which are often more aggressive with more rapid growth and a tendency to early spread to the lymph nodes. Cancers of the subglottic region are rare, but they also have a tendency for early spread.