Detection of laryngeal tumors and tumoral extension by multislice computed tomography-virtual laryngoscopy (MSCT-VL)

Abstract

Virtual endoscopy is becoming a widely used non-invasive clinical diagnostic tool. The present study was designed to compare the sensitivity and specificity of the conventional endoscopy and virtual laryngoscopy with respect to laryngeal masses. A total of 38 patients (20 males, 18 females, mean age 61 years) with the complaint of hoarseness were included in the study. Laryngeal mucosa, lumen and mass pathology were evaluated initially by direct endoscopy and then by virtual laryngoscopy during multislice CT of the larynx. Histopathologic evaluation of the masses was also made. The main pathology of the patients was found to be laryngeal masses (60% of patients, one mass for each patient), which were polyps (n = 8), papilloma (n = 4) and carcinoma (n = 11) according to histopathologic evaluation. Retrospective evaluation of 6 lesions detected in virtual but not in conventional laryngoscopy resulted with the finding of viscous-dense mucous secretion. On the contrary, three lesions detected by conventional laryngoscopy could not be detected by virtual evaluation. A total of six patients were evaluated and considered as normal both by conventional and virtual laryngoscopic examinations. Sensitivity of the virtual laryngoscopy was 88% (23/26) while its specificity was only 50% (6/12). Positive and negative predictive values were 79% (23/29) and 66% (6/9), respectively. Accuracy of the virtual laryngoscopy was 76% (29/38). Virtual laryngoscopy is not an alternative to conventional laryngoscopy but may assist direct endoscopy without causing additional radiation exposure or discomfort to the patient. The three-dimensional contribution to interpretation of the results and subsequent manipulation of the data can be used for educational and surgical purposes.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

“…We obtained from their combination a final 95% CI 0.51-0.88 for Se and a value of 95% CI 0.55-0.96 for Sp, reporting a very high I 2 value for both Se (87.7%) and Sp (95.91%), where the lowest rates of Se were reported by Hartl et al (220) and Allegra and colleagues (218), whilst Gordin and Beser (191,222) showed the lowest rate for Sp. Here the hypothesis of hegemony among these different studies was not statistically significant ( Figure 16).…”

Checking for voice disorders without clinical intervention: The Greek and global VHI thresholds for voice disordered patients

“…The European Laryngeal Society (ELS) 4,5 included this type of evaluation in a basic voice assessment protocol. This protocol included endoscopy 6–8 and acoustic, auditory-perceptual and aerodynamic evaluations 9–18 after voice therapy or phonosurgical treatments 19,20 .…”

Virtual endoscopy—a new assessment tool in difficult airway management

“…Virtual endoscopy has the added advantage that it can also be used for educational purposes, as an excellent research tool for understanding and teaching normal and abnormal pathology and in surgical planning, all without the need for additional radiation exposure or discomfort to the patient [20,24] provided staging CT images have already been undertaken.…”