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For descriptive purposes the larynx may be divided into the true vocal cords (the glottis), the area above the cords (the supraglottis) and the area immediately below the cords (subglottis). The majority of laryngeal cancers in the UK and US develop on the true vocal cord. The typical presentation is with painless hoarseness. A relatively small disturbance of the smooth surface of a vocal cord leads to the development of marked hoarseness, and tumours a few millimetres in diameter in this situation will cause noticeable alterations in the voice. It is therefore essential that all new cases of hoarseness are examined by the laryngologist.