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Dynamic radiographic imaging following total laryngectomy
H Muller-Miny1, D W Eisele, B Jones
1Russell H. Morgan Department of Radiology and Radiologic Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Head & Neck
|July 1, 1993
Summary
Cineradiography effectively visualizes post-total laryngectomy changes in the pharynx. This imaging technique identifies common findings like narrowing and pseudodiverticula, aiding in the assessment of patients with squamous cell carcinoma.
Area of Science:
- Radiology
- Otolaryngology
- Oncology
Background:
- Total laryngectomy is a surgical procedure for advanced laryngeal cancer.
- Postoperative assessment of pharyngeal changes is crucial for patient management.
- Radiographic evaluation can identify structural and functional alterations after surgery.
Purpose of the Study:
- To evaluate the utility of cinepharyngoesophograms in assessing post-total laryngectomy patients.
- To correlate radiological findings with surgical and follow-up data.
- To characterize the spectrum of radiographic abnormalities following laryngectomy for squamous cell carcinoma.
Main Methods:
- Cinepharyngoesophograms were performed on 51 patients post-total laryngectomy.
- Radiological findings were correlated with operative reports and follow-up data in 47 patients.
- Analysis focused on identifying and quantifying specific postoperative anatomical changes.
Main Results:
- Radiography effectively demonstrated postoperative anatomical changes.
- Common findings included superior surgical closure site narrowing (52%) and pseudodiverticula (47%).
- Other observed findings included cricopharyngeal prominence (15%), fistulae (10%), and pharyngeal pouches (6%).
Conclusions:
- Cineradiography is a valuable tool for visualizing functional and structural changes after laryngectomy.
- The technique helps identify common postoperative complications and anatomical variations.
- Increased retropharyngeal soft tissue thickness was not a reliable indicator of tumor recurrence.