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The neck after total laryngectomy: CT study.

D J DiSantis, D M Balfe, R E Hayden

    Radiology
    |December 1, 1984
    PubMed
    Summary
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    Computed tomography (CT) aids in detecting recurrent head and neck cancer after total laryngectomy. It reveals normal postoperative changes and identifies masses in lymph nodes, tracheostomy, or paratracheal regions, guiding treatment decisions.

    Area of Science:

    • Radiology
    • Oncology
    • Head and Neck Surgery

    Background:

    • Total laryngectomy is a common treatment for advanced laryngeal cancer.
    • Postoperative assessment for recurrent neoplasm is crucial for patient management.
    • Computed tomography (CT) is a valuable imaging modality in head and neck oncology.

    Purpose of the Study:

    • To define the normal postoperative appearance of the neopharynx on CT scans after total laryngectomy.
    • To evaluate the efficacy of CT in identifying recurrent neoplasm in these patients.
    • To assess the role of CT in differentiating recurrence from other postoperative changes.

    Main Methods:

    • Retrospective analysis of CT scans from 23 patients who underwent total laryngectomy.
    • Correlation of CT findings with clinical evidence of recurrence, abscess, or stricture.

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  • Detailed description of normal postoperative CT features and manifestations of recurrence.

    • Main Results:

    • Normal postoperative CT showed a round/ovoid neopharynx with intact surrounding fat planes.
    • Recurrent neoplasm manifested as masses in lymph nodes, tracheostomy, or paratracheal regions.
    • CT accurately identified recurrence in 12 patients, distinguished from abscess or metastases in 2, and showed strictures in 8.

    Conclusions:

    • CT is effective in assessing recurrent neoplasm after total laryngectomy.
    • CT findings supplement physical and mirror examinations for diagnosis and staging.
    • CT imaging aids in planning the therapeutic approach for recurrent head and neck cancer.