[Imaging of laryngotracheal stenoses in early and stabilized phases]

The contribution of new imaging modalities in the evaluation of laryngo-tracheal stenoses has been growing in recent years. This is due of the possibility of better investigate lesions which are difficult to assess by physical evaluation and of better identify the spread to the deep structures of malignant lesions. Congenital lesions require a chest x-ray as a first step examination, followed by an MRI study or a spiral CT study in order to identify vascular anomalies or mediastinal masses. Inflammatory stenoses are usually investigated by CT, while MRI seldom adds new data to those demonstrated by CT. The latter is mandatory in all traumatic stenoses because it allows an easy identification of fractures or dislocation of cartilages and hyoid bone. Scarring stenoses due to intubation or tracheotomy are also investigated by CT. CT or MRI are essential for the study of neoplastic stenoses. In these patients an ultrasound study and is also recommended permits the identification of abnormal lymphnodes and their US-guided fine needle aspiration. Stenoses due to compression originating from external structures require conventional studies of chest, trachea and esophagus. In these patients the differential diagnosis is reached by means of US, CT or MRI, according to the information provided by conventional studies. Finally, spiral CT is considered the most valuable tool to investigate and to plan the treatment in all the lesions which can undergo endoscopic therapy.