[Squamous cell carcinoma of the anterior commissure and penetration of the laryngeal framework].

61 glottic and 57 supraglottic advanced carcinomas of the larynx were investigated histologically by serial coronal sections. 29 glottic cancers spreading out more horizontally also rose from the anterior commissure. 7 supraglottic and 24 glottic carcinomas with a vertical extension to the sub- or supraglottic space involved the anterior commissure or the anterior subglottic wall secondarily. After a short introduction in the actually known principles of the anatomy of laryngeal cancer the behaviour of squamous cell carcinomas at the anterior commissure is reported. Carcinomas of the anterior commissure have a high tendency to involve the anterior subglottic wall. Tumour growth in this area is the most important condition for penetration of the laryngeal framework. Nearly all these cancers broke through the lower frontal ossified part of the thyroid cartilage without or including the cricothyroid membrane. Therefore glottic cancers with subglottic spread also preferred this direction to the prelaryngeal space. The importance of further histological findings for the technique of partial laryngectomy is discussed. More than half of the investigated carcinomas were treated by a planned preoperative irradiation of 3000 rad. By comparison with the posterior regions the frontal areas of these tumours showed microscopically a lower visible response to the radiotherapy. In our opinion this indicates that radiation failure in carcinomas of the anterior commissure is caused by the usually applied cross field radiation technique.