This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Larynx, Subject name: ENT
Most common presentation of- glottis carcinoma 
Select and explain. 
A. Change in voice, B. Dysphagia, C. Pain, D. Involvement of lymph nodes
A: Change in voice
Answer: A: Change in voice 
Explanation: (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 (1-2%)Nodal 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