Usefulness of ultrasonography in assessment of laryngeal carcinoma

Abstract

Objective: To evaluate the usefulness of ultrasonography in assessing laryngeal cancer. Methods: 72 patients with laryngeal carcinoma proven by surgery and pathology were enrolled. The pre-therapeutic ultrasonography and CT images were retrospectively evaluated, including tumour detection, localisation and invasion of intra-and extralaryngeal structures. A comparative assessment was made between the detection rate, correspondence rate of localisation and sensitivity and specificity of ultrasonography and CT. The mobility of the larynx was observed on real-time ultrasonography and compared with laryngoscopy. Results: The detection rate of ultrasonography [63 (87.5%)/72] was lower than that of CT [72 (100.0%)/72] (p50.006). The primary foci were accurately located in 59 (93.7%) of 63 lesions using ultrasonography compared with 70 (97.2%) of 72 lesions using CT (p50.392). In the evaluation of invasion, the sensitivity and specificity of ultrasonography were similar to that of CT in most of the intra-and extralaryngeal structures (p50.059-1.000). A higher specificity was obtained during the assessment of the paraglottic space involvement when using ultrasonography than CT (94.9% vs 66.7%, p50.001). For vocal cord fixation, no statistical difference was found between ultrasonography and laryngoscopy (p50.223). Conclusion: Ultrasonography could be used as a valuable supplementary imaging method to CT and laryngoscopy in the assessment of laryngeal carcinoma, even in male adults with some calcifications of the thyroid cartilage. Advances in knowledge: Our study demonstrates that ultrasonography, which has been used scarcely in the larynx, could supply useful information on the detection, localisation and intra-and extralaryngeal invasion of laryngeal carcinoma.

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

“…Commonly, these structures are isoechoic or hyperechoic, which provide a contrast with a hypoechoic invading tumor (159). Hence, a high sensitivity and specificity has been achieved by ultrasonography in the evaluation of involvement of these structures and reported in literature (160,162,163). For instance, Kraft et al (164) established anatomical landmarks for laryngeal endosonography (see Table 8) in order to allow a correct interpretation of sonographic images of its structures, and its known capacity to visualize critical regions such as the pre-epiglottic and paraglottic space endoscopically.…”

Squamous Cell Carcinoma of the Larynx

“…In addition, air in the laryngeal cavities could further limit evaluation. 1,7 Articles in the literature have supported the use of ultrasound of the larynx when there is a clinical concern for vocal cord paralysis, damage to the recurrent laryngeal nerve, and airway evaluation. Ultrasound may be favored in these circumstances because of its capability for dynamic real-time imaging.…”

“…Ultrasound may be favored in these circumstances because of its capability for dynamic real-time imaging. 1,8 These studies should be performed using highfrequency transducers. Patients should be imaged in the supine position, from the hyoid bone to the level of the cricoid cartilage in the transverse and longitudinal planes.…”

“…At the level of the glottis, dynamic maneuvers, such as talking softly, should be performed to assess vocal cord mobility. 1,7 Ultrasound has also proved useful in the evaluation of lymph node metastases, especially abnormal-appearing lymph nodes that may be subclinical or nonpalpable. It is also important to assess the relationship of abnormal lymph nodes in the neck with the adjacent neurovascular structures in the jugular chain.…”

“…Immobility or asymmetric movement of the larynx plays an important role in tumor grade and prognosis. 1 Laryngeal cancer is not simply staged based on endoscopic findings and not simply diagnosed with imaging. It is instead the integration of the two that allows for details about the mucosal extent of disease (endoscopy), the submucosal extent of disease (diagnostic imaging), and the possible invasion of critical structures.…”