Larynx and airway: stomal recurrence after laryngectomy: 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: stomal recurrence after laryngectomy

Sample item

A surgeon counselling a patient before total laryngectomy lists risk factors for recurrence at the tracheostoma. Which of the following is a recognised risk factor?

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

The answer and the reasoning

C. Subglottic extension of the tumour

Stomal recurrence is linked to subglottic extension, paratracheal nodal metastasis and a preoperative tracheostomy, and is commoner in advanced disease. Postoperative radiotherapy to the stoma lowers the risk. Voice prostheses do not cause stomal recurrence.

Option by option

  • A. Early T1 glottic carcinoma

    T1 glottic tumours are usually treated by radiotherapy or laser without laryngectomy.

  • B. Supraglottic origin with no nodal disease

    A supraglottic tumour without nodes does not extend to the stoma area, and carries little stomal risk.

  • C. Subglottic extension of the tumour (correct)

    Correct. Subglottic spread and paratracheal nodes seed the tracheostoma, increasing recurrence.

  • D. Use of a tracheoesophageal voice prosthesis

    A voice prosthesis is for speech rehabilitation and does not increase stomal recurrence.

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 C, Subglottic extension of the tumour. Stomal recurrence is linked to subglottic extension, paratracheal nodal metastasis and a preoperative tracheostomy, and is commoner in advanced disease.

Why is "Early T1 glottic carcinoma" not the answer?

T1 glottic tumours are usually treated by radiotherapy or laser without laryngectomy.

Why is "Supraglottic origin with no nodal disease" not the answer?

A supraglottic tumour without nodes does not extend to the stoma area, and carries little stomal risk.

Why is "Use of a tracheoesophageal voice prosthesis" not the answer?

A voice prosthesis is for speech rehabilitation and does not increase stomal recurrence.

What concept does this question test?

It tests Larynx and airway: stomal recurrence after laryngectomy in ENT. Postoperative radiotherapy to the stoma lowers the risk. Voice prostheses do not cause stomal recurrence.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: stomal recurrence after laryngectomy?

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.