Benha M. J.
Vol. 23 No 3 Sept. 2006
Comparative Study Between Virtual Laryngoscopy And
Direct Laryngoscopy In Diagnosis Of Cancer Larynx
Ahmed Seleit MD, Moharram El Badawy* MD, Ahmed S.El-Kady MD and Shreef A. Aziz ** MD.
Departments of Otorhinolaryngology, Radiology* and Surgical oncology**, Faculty of Medicine and National Cancer Institute*`**, Benha and Cairo*`** universities.
The purpose of this study was to evaluate the accuracy, clinical value and limitation of virtual laryngoscopy in diagnosis of cancer larynx in comparison to direct laryngoscopy with histopathological correlation. Thirty patients diagnosed clinically and proved pathologically as laryngeal carcinoma were subjected to fiberoptic endoscapy (FO), biopsy, spiral computed tomography (CT), and virtual laryngoscopy (VL). The accuracy of fiberoptic endoscopy, virtual laryngoscopy and CT was estimated with pathological correlation. It was found that, the accuracy of fiberoptic endoscopy, virtual laryngoscopy and CT for detection of the site of the lesion was different. Regarding to the epiglottis, the accuracy of FO, VL and CT, were 100%. As for the false vocal cord, the accuracy of FO was 81% while CT and VL were 100%. For the ventricle, the accuracy of FO was 71% while VL and CT were 100% .For the true vocal cord, the accuracy of F O was 70% while in CT and VL was 100%. For the anterior commissure, the accuracy of F O was 72%, VL was 94% and CT was 100%. For the posterior commissure, the accuracy of F O was 50%, VL was 83% and CT was 100%. For the subglottic region, the accuracy of FO was 62% while 100% in virtual and CT. For the vallecullae, the FO, VL and CT showed the same accuracy, 100%. In conclusion, virtual laryngoscopy is sensitive in assessment of the larynx beyond the large supraglottic and glottic masses obscuring the view of fiberoptic endoscopy. It is particularly useful in the presence of sever laryngeal stenosis especially in the subglottic regions and does not require sedation and additional scanning. It is of a value in follow up patients with previous laryngeal carcinoma treated by radiotherapy or conservative surgery. On the other hand, virtual laryngoscopy show limits in the identification of early laryngeal lesion which can be detected by fiberoptic endoscopy.