RADIOLOGIC APPEARANCE OF THE IRRADIATED LARYNX .1. EXPECTED CHANGES

PURPOSE: To present the expected appearance of the irradiated larynx a nd neck as seen at computed tomography (CT). MATERIALS AND METHODS: Si xty-one patients with primary squamous cell carcinoma of the larynx or hypopharynx were treated with radiation therapy. All patients underwe nt CT before and after treatment. RESULTS: Expected changes include sy mmetric thickening of the epiglottis, aryepiglottic folds, and false c ords and increased attenuation of the paralaryngeal fat. The posterior pharyngeal wall tends to thicken and its mucosa enhances; retropharyn geal space edema is common. Glottic changes include increased attenuat ion of the paraglottic fat planes and thickening of the anterior and p osterior commissures. Subglottic changes include thickening of the muc osa and submucosa. Soft-tissue changes include skin and platysmal thic kening, as well as reticulation and increased attenuation of the subcu taneous and deeper fat. CONCLUSION: Familiarization with expected radi ologic changes is essential far interpretation of CT images of the irr adiated larynx so that such changes are not mistaken for signs of pers istent or recurrent tumor.