Abstract
Seventy-nine patients with carcinoma of the larynx were studied for staging of the disease. Three procedures were employed for staging : physical examinations, laryngography and CT scan. Of the 79, 57 patients underwent an operation and their excised specimens were histologically studied. The histological findings were compared with the preoperative staging. The accuracy of T staging based on physical examinations was 51.6%, that by means of laryngograms was 57.7%, and that by CT was 89.5%. CT was particularly useful to accurately diagnose T 4 lesions. Fixation of the vocal cord is a criterian for the diagnosis of T 3 stage. For the staging by CT, obliteration of the paraglottic space and dislocation of the arytenoid cartilage were employed as criteria for T 3 lesions. Fifty-five percent of the patients showed the both CT findings. In the cases of glottic and subglottic carcinoma, vocal cord fixation was diagnosed on the basis of obliteration of the paraglottic space alone, while, in the cases of supraglottic and epilaryngeal carcinoma, fixation was diagnosed on the basis of dislocation of the arytenoid cartilage alone. Preepiglottic space invasions seen on CT were classified into ulcer type and infiltration type. They were correctly diagnosed by CT. CT was also useful for diagnosis of extralaryngeal involvements including oropharyngeal and hypopharyngeal involvements. Only 9.1 % of cases of cartilage destruction were detected by palpation, while 90.9% of cartilage involvements were diagnosed by CT.
