Radiologic appearance of the irradiated larynx. Part I. Expected changes

Abstract

Purpose: To present the expected appearance of the irradiated larynx and neck as seen at computed tomography (CT).

Materials and methods: Sixty-one patients with primary squamous cell carcinoma of the larynx or hypopharynx were treated with radiation therapy. All patients underwent CT before and after treatment.

Results: Expected changes include symmetric thickening of the epiglottis, aryepiglottic folds, and false cords and increased attenuation of the paralaryngeal fat. The posterior pharyngeal wall tends to thicken and its mucosa enhances; retropharyngeal space edema is common. Glottic changes include increased attenuation of the paraglottic fat planes and thickening of the anterior and posterior commissures. Subglottic changes include thickening of the mucosa and submucosa. Soft-tissue changes include skin and platysmal thickening, as well as reticulation and increased attenuation of the subcutaneous and deeper fat.

Conclusion: Familiarization with expected radiologic changes is essential for interpretation of CT images of the irradiated larynx so that such changes are not mistaken for signs of persistent or recurrent tumor.