The value of CT scans in improving laryngoscopy in patients with laryngealcancer

This retrospective study assessed the value of computed tomography (CT) sca n with contrast in improving the staging accuracy of indirect and direct la ryngoscopy. We compared the preoperative staging obtained by the two latter procedures with postoperative histopathological findings in 187 patients o perated on for laryngeal cancer. Of these cancers, 98 were supraglottic, 82 glottic and 7 subglottic in origin. The staging accuracy of laryngoscopy w as 51.3% and CT was 70.1%. When the two procedures were combined, the stagi ng accuracy was 80.2%. The accuracy of the CT increased from glottic to sup raglottic to subglottic tumors, although the accuracy of laryngoscopy decre ased in the same direction. Laryngoscopy alone tended to understage larger tumors (pT3 and pT4), whereas CT underestimated the smaller ones (pT1 and p T2). Our data suggest that in order to plan the best treatment both laryngo scopy and CT should be used in making the diagnosis.