Diagnosis of carcinoma of the larynx: a review of current methods.

There is a need to establish the diagnosis of cancer of the larynx as early as possible. Delay in making the diagnosis should occur rarely if all of the available methods are fully utilized. Having established the presence of a carcinoma it should be possible to define the site and extent of the tumor; only with this additional information can the best treatment be selected. The use of a fiber-optic laryngoscope or a telescopic laryngoscope (Gould) has made examination of the "difficult larynx" more satisfactory. X-ray examination, with or without contrast material, has provided useful information regarding extent of the tumor, particularly with regard to its relation to the glottis. Microscopic laryngoscopy has proven to be a most reliable way to identifying "the early lesion" and of establishing the extent of an established tumor, especially if supravital staining is applied and the microsurgical laryngeal mirror and laryngeal caliper are used. The most difficult diagnosis to make at the present time is the presence of residual tumor after radiation, when the tumor does not present on the surface. The solution to this problem will not be found easily.