Abstract:
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Purpose: To determine whether laryngeal cartilage abnormalities, as seen on preoperative CT, in patients with squamous cell carcinoma of the larynx or piriform sinus, are associated with a worse local outcome after partial laryngectomy.
Methods and Materials: The preoperative CT studies of a consecutive series of 16 patients who underwent primary hemicricolaryngectomy for squamous cell carcinoma of the glottis (n=13) or piriform sinus (n=3) were retrospectively reviewed. The clinical staging was: T2N0: n=4; T3N0: n=9; T4N0: n=1; T3N2: n=2 . All CT studies were evaluated for cartilage abnormalities, defined as asymmetric sclerosis (thickening of the cortical margin and/or increased medullary density, comparing one arytenoid to the other, or one side of the cricoid or thyroid cartilage to the other side), lysis (destruction of ossified cartilage) and tumor visible on both sides of the cartilage. Seven patients underwent postoperative radiotherapy. All patients were followed-up for at least 24 months after treatment.
Results: Eleven patients showed cartilage abnormalities (arytenoid: n=8; cricoid: n=3; thyroid: n=7). In 6 patients only a single cartilage was abnormal, whereas 3 patients showed involvement of two and 2 patients of three cartilages. Two patients suffered from local recurrence. One of these patients did not show cartilage abnormalities on the preoperative CT examination. The other patient had extensive involvement of all cartilages and evidence of early transcartilageneous tumor spread.
Conclusion: In patients whose cancer is anatomically suitable for partial laryngectomy, laryngeal cartilage abnormalities do not preclude speech preserving surgery.
Thoeny MD, H,
Local Outcome after Partial Laryngectomy: Correlation with Cartilage Abnormalities on CT. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3106569.html
