The Diagnostic Accuracy of the Clinical Examination and the Computed Tomography Findings in Patients with Laryngeal Carcinoma who Undergone Total Laryngectomy

Abstract

Objectives:An accurate pretherapeutic evaluation of laryngeal carcinoma is required for treatment planning as well as for evaluation and comparison of the results of different treatment modalities. The purpose of our study was to determine whether microlaryngoscopic findings and CT imaging correlate with histopathological findings or not.Material and Methods:In this study, thirty-five cases of laryngeal cancer with deeply invading up to the limits of larynx or extralaryngeal extension were studied. Each patient had a history, clinical evaluation (including microlaryngoscopy and biopsy), and CT examination. The surgical specimens were cut in whole-organ slices parallel to the plane of the axial CT images. The histological findings were compared with the clinical and CT findings. The impact of each diagnostic method on pretherapeutic evaluation was analyzed.Results:Clinical evaluation alone failed to identify tumour invasion of the laryngeal cartilages and of the extralaryngeal soft tissues, resulting in a low staging accuracy (57%). The combination of clinical evaluation and an additional CT imaging resulted in significantly improved staging accuracy (86%).Conclusion:An interdisciplinary evaluation of clinical, endoscopical, and radiological findings is mandatory to detect the involvement of deep laryngeal or extralaryngeal tissues.

Keywords

• laryngeal neoplasm
• laryngeal endoscopy
• ct imaging of larynx
• whole organ sections of larynx.