CT FINDINGS IN CHONDRORADIONECROSIS OF THE LARYNX

PURPOSE: Our goal was to describe the CT findings before and after rad iation therapy in a series of patients with laryngeal chondroradionecr osis. METHODS: The CT studies obtained before and after radiation ther apy in nine patients with the diagnosis of laryngeal chondroradionecro sis were reviewed retrospectively. RESULTS: CT scans revealed abnormal ities in all patients, A variable degree of laryngeal soft-tissue swel ling was seen in eight of the patients. In four patients, cartilaginou s abnormalities were visible initially, and appeared in three of four other patients who had further follow-up CT studies, Six patients had involvement of the thyroid cartilage; collapse of the thyroid cartilag e was seen in two cases and gas bubbles were visible adjacent to the t hyroid cartilage in three cases. Four patients with involvement of the thyroid cartilage eventually underwent total laryngectomy, and one di ed suddenly in severe respiratory distress. In all three patients with arytenoidal involvement, anterior dislocation of this cartilage was s een; in two of these patients, the adjacent part of the cricoid cartil age showed some sclerosis, Two patients with arytenoidal necrosis (bot h with cricoidal sclerosis) kept a functional larynx. In one case, cri coidal sclerosis was seen in association with lysis of the thyroid car tilage. CONCLUSION: The CT appearance of laryngeal chondroradionecrosi s is nonspecific, but the diagnosis can be strongly suggested in cases of sloughing of the arytenoid cartilage, fragmentation and collapse o f the thyroid cartilage, and/or in the presence of gas bubbles around the cartilage.