<prompt> Most common presentation of- glottis carcinomaChange in voiceDysphagiaPainInvolvement of lymph nodes  <response>: A Change in voice 309- Dhingra 6th Hoarseness of voice is an early sign because lesions of cord affect its vibratory capacity, it is because of this that glottis cancer is dectected early. SUPRAGLOTTISGLOTTISSUBGLOTTISSites Epiglottis Aryepiglottic folds Arytenoids Ventricular bands Ventricles and sacculeTrue vocal cordsAnterior commissurePosterior commissureWalls of subglottis up to lower border of cricoid cartilageFrequencyLess frequent than glottisMost commonLeast common 1-2Nodal metastasisNodal metastasis occur early- upper and deep cervical nodesNodal metastasis is rare- Practically naver seenNodal metastasis in pre-laryngeal pre- tracheal, para tracheal and lower deep cervical nodesNot as common as in supraglottis varietyMost prominent symptomOfter silent Hoarsness is lateHoarseness is anearly signStridor or Laryngeal obstructionHoarseness is late Any patient in cancer age group having persistent or gradually increasing hoarseness for 3 weeks must have laryngeal examination to exclude cancer 