Computed tomography in determining laryngeal involvement of hypopharyngeal carcinoma

In 22 patients with hypopharyngeal carcinoma, the extent of laryngeal involvement was estimated preoperatively by means of computed tomography and visual inspection including mirror examination and fiberscopic and strobofiberscopic video recordings. All patients underwent laryngopharyngectomy, and the surgical specimens were subjected to a whole organ section study. The results of the preoperative evaluations were related to the histopathologic findings. Computed tomography was reliable for the estimation of paraglottic space involvements. It was also useful in detecting carcinomatous invasion into the preepiglottic space and aryepiglottic fold, but there were some false positives for these structures. It was not always reliable in assessing invasion of the laryngeal cartilages. It provided a very accurate estimation of involvement for the thyroarytenoid muscle and a considerably accurate assessment for the lateral cricoarytenoid and interarytenoid muscles and the recurrent laryngeal nerve. It was useful in detecting involvement of the posterior cricoarytenoid muscle, but there were a fair number of false positives. For the cricothyroid muscle, the estimation based on CT was not very reliable. Some erroneous judgments on CT were corrected in a comprehensive evaluation that included visual inspection.