Ultrasonography in laryngeal cancers

Area of Science:

• Oncology
• Diagnostic Imaging
• Otolaryngology

Background:

• Conventional endoscopy has limitations in assessing the full extent of laryngeal tumors, particularly outward extension.
• Accurate staging of laryngeal cancer is crucial for effective treatment planning and patient outcomes.
• Detecting subclinical cervical lymph node metastasis is vital for comprehensive laryngeal cancer management.

Purpose of the Study:

• To evaluate the efficacy of high-resolution ultrasonography (US) in assessing the endolaryngeal and extralaryngeal spread of laryngeal epidermoid carcinoma.
• To compare the diagnostic accuracy of US with clinical, operative, and histopathological findings.
• To determine the sensitivity and specificity of US in detecting metastatic lymph nodes in patients with laryngeal cancer.

Main Methods:

• High-resolution real-time ultrasonography was performed on 34 patients diagnosed with laryngeal epidermoid carcinoma.
• Ultrasonographic findings were correlated with clinical examination, surgical exploration, and histopathological analysis.
• Sensitivity and specificity of US for detecting tumor extension and lymph node metastasis were calculated and compared to palpation.

Main Results:

• Ultrasonography accurately identified malignant extensions into the thyroid cartilage (9 cases), carotid artery (4 cases), and thyroid gland (5 cases), confirmed histopathologically.
• US diagnosed subclinical cervical lymph node metastasis in 6 out of 34 patients, which were not detected by conventional palpation.
• High-resolution US demonstrated a sensitivity of 94.44% and a specificity of 93.75% for laryngeal cancer evaluation and metastasis detection.

Conclusions:

• High-resolution real-time ultrasonography is a highly sensitive and specific imaging modality for evaluating the extent of laryngeal cancers.
• US is effective in detecting both extralaryngeal tumor spread and subclinical cervical lymph node metastasis, outperforming traditional palpation.
• Ultrasonography represents a simple, inexpensive, and valuable tool for the comprehensive assessment of laryngeal cancer patients.