[Evaluation of laryngotracheal stenosis with spiral CT three-dimensional images and clinical application].
OBJECTIVE
To study the use of spiral computed tomography three-dimensional images (SCT-3DI) in the evaluation of patients with laryngotracheal stenosis. The value and utility of SCT-3DI compared with actual endoscopy were also investigated in terms of accuracy of diagnosis and validity of treatment.


METHODS
Eight patients with laryngotracheal stenosis were underwent SCT-3DI and regular endoscopy examination preoperatively. Of eight patients, Five had traumatic causes, two with tracheal narrowing due to tracheal granulomas, one with too much scar tissue of unknown etiology in the subglottic area. The location, extent and contour of the stenosis were identified and compared with actual endoscopy findings, and confirmed by surgical procedures.


RESULTS
SCT-3DI evaluation was accurate in assessing the length, width and shape of all the laryngotracheal stenosis in our study. The results of SCT-3DI were best correlated with actual endoscopy findings and those found in the surgery. Based on the SCT-3DI, five patients were treated by open surgical techniques including laryngotracheal reconstruction procedures and dilation methods with hyoid grafts or stents. Two undertaken endoscopic treatment with CO2 laser excision of scar tissue or granulomas, one accepted no surgical procedures. All eight patients were successfully decannulated with improved voice and satisfied airway after 6-month postoperative follow-up.


CONCLUSIONS
Evaluation of the upper airway with SCT-3DI is useful in the diagnosis, measurement, and definition of the laryngotracheal stenosis. Objective data obtained from SCT-3DI is very helpful for operative scheme. Patients treated with appropriate procedures best suited for every stenosis have reached satisfactory clinical results.
Qin
Yong
Y
Department of Otorhinolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China. qinyong@public.bta.net.cn
Gao
Wei-hua
WH
Li
Zhi-guang
ZG
Tang
Guang-jian
GJ
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007829:Laryngostenosis / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D036542:Tomography, Spiral Computed; D014135:Tracheal Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery