الفهرس 
Introduction18Only 14 pages are availabe for public view
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Abstract
The aim of this work is to assess the reliability of MDCT in
evaluating patients with laryngeal tumors.
Summary & Conclusion
An accurate pre-therapeutic staging of laryngeal cancer is necessaryin order to have precise indications for treatment planning. Contrastenhanced CT has been proved to be an important procedure in estimating the location, size, vertical limits and deep extension of tumor, and the presence of metastatic lymph nodes, especially in presumed clinically negative or obese necks.
Direct visualization of the mucosa and biopsy availability in conventional laryngoscopy counteracts the disadvantages such as being invasive and requiring sedation, and the dependence of the assessment to operator’s experience. Failure to observe lesions beyond stenosis or obstruction and limited viewing restricted to the lumen is among important disadvantages of the conventional method.
Virtual laryngoscopy or tracheoscopy, based on perspective volume rendering, is a non invasive, valid method which delivers anatomical impressions (comparable to an endoscope) of the hypopharynx, larynx and the trachea. Stenosis or even total obstructions are no hindrances for virtual endoscopy and every viewing angle is possible. The assessment of the surrounding structures, tumor extension and the lymph node metastases is possible simultaneously with the axial CT images.
In our study, there were 40 patients, proved by pathological analysis of biopsies to be laryngeal tumors, thirty five of them were diagnosed as squamous cell carcinoma and only one was diagnosed as neurofibrosarcoma. Most of total our cases (90% of cases) were males. The most common complaint of patients was hoarseness of voice.
As regarding the thirty sex cases diagnosed as squamous cell carcinoma, that were the commonest, the MDCT was more effective than direct laryngoscopy in detection of pre-epiglottic extension, paraglottic extension, cartilage invasion, extra laryngeal extension, anterior commissure extension as well as accurate detection of the real craniocaudal extension of lesions. On the other side, the direct laryngoscopy could detect the motility of vocal cords.
Also axial images were more effective than saggital images in detection of anterior commissure involvement and pre-epiglottic extension also were more effective than coronal images in detection of paraglottic extension. On the other side, the saggital and coronal images were more effective than axial images in detection of nodal involvement.
The CTVL was more effective than direct laryngoscopy in detection of anterior commissure involvement, posterior commissure involvement,
subglottic extension as well as vocal cord involvement by lesions.
As regarding the four patients with benign papilloma, the lesions were small in size and thus could not be detected by MDCT axial, saggital and coronal images. However, all lesions could be detected by CTVL.