Larynx Anatomical sites and subsites of the three regions of the larynx: supraglottis, glottis, and subglottis. Supraglottis (C32.1) subsites include suprahyoid epiglottis (i), aryepiglottic fold, laryngeal aspect (ii), infrahyoid epiglottis (iv), and ventricular bands or false cords (v). Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx Anatomical sites and subsites of the supraglottis and glottis. Supraglottis (C32.1) subsites include suprahyoid epiglottis (i), aryepiglottic fold, laryngeal aspect (ii), arytenoids (iii), and ventricular bands or false cords (v). Glottis (C32.0) subsites include vocal cords (i), anterior commissure (ii), and posterior commissure (iii). Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T1 for the supraglottis is defined as tumor limited to one subsite of supraglottis (shown here in the ventricular bands) with normal vocal cord mobility Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T1 for the supraglottis is defined as tumor limited to one subsite of supraglottis (shown here in the ventricular bands) with normal vocal cord mobility Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T2 for the supraglottis is defined as tumor invading the mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula, medial wall of pyriform sinus) without fixation of the larynx (shown here with tumor involvement in the suprahyoid and mucosa of the infrahyoid epiglottis). Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T2 for the supraglottis with invasion of ventricular bands (false cords) and the epiglottis. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T3 for the supraglottis is defined as tumor limited to larynx with vocal cord fixation and/or invading any of the following: postcricoid area, pre-epiglottic tissues, paraglottic space, and/or inner cortex of thyroid cartilage, here with invasion of the supraglottis and vocal cord with vocal cord fixation. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T3 for the supraglottis with invasion of the pre-epiglottic tissues with vocal cord fixation. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T4a for the supraglottis is defined as moderately advanced local disease, tumor invading through the thyroid cartilage and/or invading tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus). Here, tumor has invaded beyond the larynx into the vallecula and base of the tongue as well as into soft tissues of the neck. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx Cross-sectional illustration of T4b tumor for the supraglottis, which is defined as very advanced local disease, invading prevertebral space, encasing the carotid artery (shown), or invading mediastinal structures. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T1 tumors of the glottis are limited to the vocal cord(s) with normal mobility (may involve anterior or posterior commissure). T1a tumors are limited to one vocal cord (top right) and T1b tumors involve both vocal cords (bottom right). Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T2 tumors of the glottis extend to supraglottis and/or subglottis, and/or with impaired vocal cord mobility. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T3 tumors of the glottis are limited to the larynx with vocal cord fixation (shown), and/or invades paraglottic space, and/or inner cortex of the thyroid cartilage. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T4a tumors of the glottis are moderately advanced local disease and invade through the outer cortex of the thyroid cartilage and/or invade tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus). Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T1 tumors of the subglottis are limited to subglottis. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T2 tumors of the subglottis extend to vocal cord(s), with normal or impaired mobility. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T3 tumors of the subglottis are limited to larynx with vocal cord fixation. Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer Larynx T4a tumors of the subglottis are moderately advanced local disease and invade cricoid or thyroid cartilage and/or invade tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscles of the tongue, strap muscles, thyroid, or esophagus). Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer