CT of the fixed vocal cord

Area of Science:

• Otolaryngology
• Radiology
• Oncology

Background:

• Vocal cord mobility is crucial for laryngeal cancer staging and treatment decisions.
• Clinical assessment of vocal cord mobility can sometimes be misleading.
• Computed tomography (CT) offers detailed imaging of laryngeal structures.

Purpose of the Study:

• To evaluate the utility of CT scanning in assessing vocal cord mobility in patients with suspected laryngeal cancer.
• To compare CT findings with clinical assessments of vocal cord mobility.
• To differentiate between tumor-induced immobility and immobility due to other causes like trauma.

Main Methods:

• Seventy-one patients with clinically assessed vocal cord mobility status underwent CT scanning.
• CT scans were analyzed for tumor extension and other causes of vocal cord fixation.
• Correlation between CT findings and clinical diagnosis was performed.

Main Results:

• CT correctly predicted vocal cord fixation in 16 of 19 tumor patients and 8 of 9 trauma patients.
• CT identified two cancers as more advanced than clinically estimated due to preepiglottic or subglottic involvement.
• CT revealed that "occult" trauma mimicked laryngeal tumors by limiting vocal cord mobility in three patients.
• Cricoarytenoid joint involvement and paralaryngeal space spread were common in tumor-related fixation.
• Laryngeal skeleton injuries and soft tissue changes were frequent in trauma-related fixation.

Conclusions:

• CT scanning is a valuable tool for assessing vocal cord mobility in laryngeal cancer.
• CT imaging can accurately distinguish between tumor-related and trauma-related vocal cord immobility.
• Utilizing CT can prevent misdiagnosis and guide appropriate treatment strategies for laryngeal conditions.