The diagnosis is usually made on history and the most important examination tool is the flexible nasopharyngolaryngoscope, which would be done in the rooms and ideally identify the laryngeal lesion.  Depending on the working diagnosis, investigations would continue, or treatment implemented. 

Investigations: The most useful is a CT scan of the neck and the chest together with Ultrasound of the neck.  Plain x-rays, contrast dynamic Swallows and MRI scans are also used.  Other investigations could include blood tests and sputum analysis.  The definitive diagnosis is often at biopsy.