Larynx: Anatomic Imaging for Diagnosis and Management

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Key Points

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    Radiologic imaging plays a critical role in guiding the diagnosis and treatment of a variety of benign and malignant diseases of the larynx along with the primary tools of laryngoscopy and biopsy.

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    Cross-sectional imaging is essential for evaluating the submucosal and deep tissues of the larynx, which are not amenable to direct visualization, and for assessing extension of disease into adjacent spaces in the neck.

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    Rapidity of image acquisition in CT is particularly advantageous for general

CT

At many institutions, including the University of North Carolina (UNC), CT is the preferred imaging modality for initial evaluation of the larynx and the neck due to its widespread availability, familiarity to clinicians, and rapidity of image acquisition. The last feature is particularly advantageous for general imaging, because it allows CT to be less susceptible to artifacts caused by swallowing and breathing, which frequently result in suboptimal or nondiagnostic MR studies. A routine neck

Imaging anatomy of the larynx

The larynx is a dynamic organ system that is responsible for maintaining and protecting the airway and allowing phonation. It maintains its shape via a rigid supporting skeleton composed of the hyoid bone superiorly and the epiglottic, thyroid, arytenoid, and cricoid cartilages more inferiorly (Fig. 1, Fig. 2, Fig. 3). These osseous and cartilaginous structures are connected by various membranes, ligaments, and joints, and their interior surfaces are covered by laryngeal epithelial mucosa,

Staging and Surveillance of Squamous Cell Carcinoma

At UNC, the most common indications for laryngeal imaging are initial staging of a suspected or biopsy-proved squamous cell carcinoma and post-treatment surveillance. In the former case, the primary goals of imaging are to evaluate the subsites of the larynx that are involved, to assess the extent of submucosal or extralaryngeal tumor spread, to detect tumor invasion of cartilage, and to identify regional spread to lymph nodes, all of which influence decisions regarding the most appropriate

Squamous Cell Carcinoma

Approximately 12,760 new cases of laryngeal cancer are diagnosed in the United States annually, with an estimated 3560 deaths caused by the disease every year.18 Of these, more than 90% are squamous cell carcinomas.8 Proper interpretation of imaging studies performed for known or suspected carcinomas of the larynx depends on knowledge of typical patterns of spread of disease based on the site of origin of the tumor, with particular attention to the findings that change the staging of the cancer

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