Evaluation of laryngeal carcinoma by computed tomography

The limitation of direct or indirect laryngoscopy and laryngogram in determining the exact site and anatomic location of laryngeal carcinoma were well documented by many authors. As compared with laryngoscopy and laryngogram, computed tomographic study for laryngeal cancer is more exact and accurate method demonstrating anatomic sites of involvement, invasion into deep soft tissue spaces of endolarynx, destruction of laryngeal cartilages and cervical metastasis. Fourteen laryngeal cancer patients proven by laryngoscopic biopsy were further examined by computed tomography for staging. The authors compared laryngoscopic findings with those of computed tomography, and their clinical, surgical and computed tomographic findings were analysed. The results were as follows; 1. All patients were proved as squamous cell carcinoma. They were 12 males and 2 females aged over 50 yr. 2. Common clinical symptoms were hoarsense, dysphagia and swallowing difficulty. The primary anatomic sites determined by CT were 8 transglottic, 2 glottic, 2 supraglottic and 1 pyriform sinus respectively. They were 2 T1, 7 T2,1 T3, 3 T4 by TNM systems, respectively. (One case was difficult to evaluate exactly). 3. Invasion into deep soft tissue spaces of endolarynx, cartilage destruction, and neck metastasis were relatively predominant in transglottic carcinomas. 4. Compute tomography was superior in evaluating tumor invasion, especially into deep sift tissue spaces of endolarynx, laryngeal cartilages and metastasis to soft tissue and lymph nodes of neck. However computed tomography had some limitation in determining primary site of laryngeal cancer.