Utility of 64 multislice CT-virtual laryngoscopy in presurgical planning of laryngeal and hypopharyngeal carcinomas

Abstract Objective To evaluate the utility of 64-multislice CT with virtual laryngoscopy in diagnosis and pre-therapeutic planning of laryngeal and hypopharyngeal carcinomas in comparison with conventional laryngoscopy. Patients and methods Forty patients with laryngeal and hypopharyngeal carcinomas were subjected to 64-multislice CT examinations with multiplanar reformation and CT-virtual laryngoscopy. The results were compared with those of direct and indirect laryngoscopy. Multiple variables like primary subsite of the mass, invasion of anterior commissure, posterior commissure and subglottic extension of mass were analyzed and the Chi-square test was used to study the association between each 2 variables. Results Excellent correlation was found between direct laryngoscopy and CTVL in detection and localization of primary subsite of laryngeal carcinomas. A statistically significant difference existed between both modalities in favor of CTVL in identifying subglottic extension, anterior and posterior commissures invasion ( P  ⩽ 0.001) as well as in evaluating the hidden areas of the hypopharynx. Direct endoscopy was more valuable, however in identifying mucosal surface irregularities and vocal cord involvement diagnosed as cord fixation (P  ⩽ 0.001). Conclusion Virtual laryngoscopy is a noninvasive and reliable technique that in combination with axial and MPR CT images is valuable in staging and pretherapeutic planning of laryngeal/hypopharyngeal carcinomas. It is not an alternative to conventional laryngoscopy but may assist direct endoscopy without causing additional radiation exposure or discomfort to the patient.