Larynx and airway: T4a glottic cancer: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Larynx and airway: T4a glottic cancer

Sample item

CT of a glottic carcinoma shows erosion through the thyroid cartilage with extension into the soft tissues of the neck. What is the standard treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Total laryngectomy with adjuvant therapy as indicated

Invasion through the thyroid cartilage into neck soft tissue is T4a disease. Primary total laryngectomy, usually with thyroidectomy and neck dissection plus adjuvant therapy, is the standard because function after non-surgical treatment is poor and cure rates are higher with surgery.

Option by option

  • A. Supracricoid partial laryngectomy

    Partial laryngectomy cannot encompass disease through the thyroid cartilage.

  • B. Transoral laser cordectomy

    Laser cordectomy is for very early, small cancers.

  • C. Definitive radiotherapy alone

    Radiotherapy alone has poor control rates when cartilage is destroyed.

  • D. Total laryngectomy with adjuvant therapy as indicated (correct)

    Correct. Cartilage destruction with extralaryngeal spread needs total laryngectomy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Total laryngectomy with adjuvant therapy as indicated. Invasion through the thyroid cartilage into neck soft tissue is T4a disease.

Why is "Supracricoid partial laryngectomy" not the answer?

Partial laryngectomy cannot encompass disease through the thyroid cartilage.

Why is "Transoral laser cordectomy" not the answer?

Laser cordectomy is for very early, small cancers.

Why is "Definitive radiotherapy alone" not the answer?

Radiotherapy alone has poor control rates when cartilage is destroyed.

What concept does this question test?

It tests Larynx and airway: T4a glottic cancer in ENT. Primary total laryngectomy, usually with thyroidectomy and neck dissection plus adjuvant therapy, is the standard because function after non-surgical treatment is poor and cure rates are higher with surgery.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Larynx and airway: T4a glottic cancer?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.