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Dynamic Computed Tomographic Evaluation of Vocal Cord Mobility in Patients With Larynx Cancer

Celebi, Irfan MD*; Mahmutoglu, Abdullah S. MD*; Vural, Cetin MD; Bankaoglu, Mujdat MD*; Caliskan, Kosti C. MD*; Erturk, Sukru M. MD*; Basak, Muzaffer MD*

Journal of Computer Assisted Tomography: July/August 2012 - Volume 36 - Issue 4 - p 416–420
doi: 10.1097/RCT.0b013e31825b85ce
Neuroradiology

Objective: To evaluate the accuracy of dynamic laryngeal computed tomography (DLCT) for the detection of vocal cord mobility in larynx cancer.

Methods: Vocal cord mobility of 44 patients (36 men; age range, 49–81 years) with larynx cancer was examined; 13 patients were excluded (owing to poor image quality or bilateral vocal cord involvement), and vocal cord mobility was evaluated for the remaining 31 patients qualitatively and quantitatively with dynamic laryngeal computed tomography during phonation, inspiration, and Valsalva maneuver phase.

Results: The mobile cords were laterally positioned in a straight configuration on inspiration phase. Phonation phase images revealed medial displacement with protrusion of the cords (shoulder sign) and ventricular niche (31 patients/42 cords). Fixed cords (13 patients/13 cords) conserved their configuration and location during all phases. The distances of the vocal cords to the midline were measured based on the images obtained during inspiration and Valsalva maneuvers. The mean ± SD difference between the movement distances of cords measured during each phase was as follows: 6.16 ± 1.64 mm for the mobile cord (n = 42) and 3.17 ± 0.78 mm for the impaired cord (n = 7) on the midcoronal plane (P = 0.0001). A comparison between the mean distance values of the mobile, impaired and fixed cords groups revealed significant distance.

Conclusions: Dynamic laryngeal computed tomography of the larynx of patients with laryngeal cancer can be used as a supplemental tool to examine cord mobilization for accurate T-staging (particularly for patient laryngoscopy, which is difficult to perform), and can provide additional information to physicians.

From the *Department of Radiology, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey; and †Department of Otolaryngology, Head and Neck Surgery, Maltepe University Faculty of Medicine, Maltepe, Istanbul, Turkey.

Received for publication February 21, 2012; accepted April 20, 2012.

Reprints: Irfan Celebi, MD, Department of Radiology, Sisli Etfal Training and Research Hospital, Etfal Sok. 34377 Sisli, Istanbul, Turkey (e-mail: irfancelebi@gmail.com).

The authors report no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.