Mobility of the arytenoid cartilage in glottic carcinoma: a CT image study

Acta Otolaryngol. 2023 Apr;143(4):309-316. doi: 10.1080/00016489.2023.2187885. Epub 2023 Mar 20.

Abstract

Background: Laryngeal carcinomas cause vocal cord (VC) mobility problems. Other than evaluation through flexible laryngoscopy, rare reports concerning CT findings for the motion of the VC or arytenoid cartilage (AC) are found.

Aims/objectives: To explore a novel evaluation of the mobility of the AC in glottic carcinoma.

Material and methods: In 39 patients with glottic carcinoma grouped upon lesion locations and AC mobilities, laryngeal CT scans were collected during inspiration and phonation. AC static position and motion data were compared between paired lesion and control sides.

Results: No significant difference showed in the group with glottic carcinoma invading the anterior 2/3 of VC. In the abnormal mobility group, significant AC position changes and weaker motion of most measurements were proved on the lesion side. Lesion invading the posterior 1/3 of VC also resulted in an adducted, medially rotated and forward-tilted AC, rotation of axial angle (RAA) was the only motion item that decreased significantly.

Conclusions and significance: In most glottic cancer cases, CT and laryngoscope had similar judgments for AC mobility. For lesions extending to the cartilaginous VC with laryngoscopically confirmed normal mobility, CT measurement of RAA showed the feasibility of being an indicator for the earliest motion problem.

Keywords: Glottic carcinoma; arytenoid cartilage; computed tomography; cricoarytenoid joint; three-dimensional reconstruction.

MeSH terms

  • Arytenoid Cartilage
  • Carcinoma* / pathology
  • Humans
  • Laryngeal Neoplasms* / pathology
  • Larynx*
  • Tomography, X-Ray Computed