Dynamic computed tomographic evaluation of vocal cord mobility in patients with larynx cancer.
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.
Department of Radiology, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey. irfancelebi@gmail.com
Irfan
I
Celebi
Abdullah S
AS
Mahmutoglu
Cetin
C
Vural
Mujdat
M
Bankaoglu
Kosti C
KC
Caliskan
Sukru M
SM
Erturk
Muzaffer
M
Basak
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D001239:Inhalation; D007472:Iohexol / Q000031:analogs & derivatives; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010699:Phonation; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014636:Valsalva Maneuver; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging* / Q000503:physiopathology
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide