CT APPEARANCE OF THE LARYNX AFTER CONSERVATIVE AND RADICAL SURGERY FOR CARCINOMAS

The purpose of this study was to evaluate the normal CT appearance of the larynx after conservative and radical surgery. Postoperative (cons ervative surgery n = 52, radical surgery n = 21) CT examinations of 73 patients suspected of local/regional recurrence (n = 53) or asymptoma tic (n = 20) were retrospectively analysed. The CT findings of 45 pati ents negative at biopsy were utilised to assess the normal appearance after surgery. Changes in the laryngeal framework represented constant landmarks, whereas the variety of soft tissues resection often result ed in a more unpredictable appearance of the neolarynx. Considerable t hickening of the mucosa covering the arytenoid cartilage(s) has been d etected after horizontal supraglottic laryngectomy (40%) or supracrico id laryngectomies (SL; 100%). A ''pseudocord'' due to scar tissue appe ared to be a constant finding following vertical haemilaryngectomy, fr equently after SL. Dilation of a lateral recess of the hypopharynx was observed after SL. This '' pharyngeal pouch'' had considerable size a nd air or liquid content. The most frequent CT findings among 28 tumou rs recurrent after conservative or total surgery were a mass larger th an 10 mm spreading beyond the larynx (63.1%), thickening of anterior c ommissure (57.9%), erosion of residual cartilages (16.9%). Although CT detected one subclinical recurrence, its employment is justified only to assess the submucosal extent of the lesion. This requires a thorou gh knowledge of normal post-operative findings.