CT of the larynx

While conventional radiographic techniques are still of value in the radiologic work-up of the patient with laryngeal disease, computed tomography (CT) has assumed a dominant role, particularly in the pretreatment staging and post-treatment evaluation of the patient with cancer. Even prior to the present generation of high resolution, fast scan equipment, images were being generated that revealed information available in no other non-invasive way, offering two major advantages. Initially, CT's ability to depict cross-sectional (axial) anatomy allows the radiologist and surgeon to build a clear three dimensional image of the site and extent of disease. Secondly, CT discriminates small soft tissue density differences. Also, this latter capability allows a separation of lymph nodes and blood vessels if the study is done with intravenous contrast enhancement. These two outstanding imaging properties allow informed decisions to be made regarding the feasibility and/or extent of conservation or radical surgery in malignant disease and provide unique and critical information regarding cartilage and deep structures. Other advantages of varying importance include the speed of the examination, its noninvasive nature, and the comfort to the patient. This paper reviews normal CT anatomy and discusses, with illustrations, the major diagnostic applications of CT in laryngeal disease.