USEFULNESS OF TRANSCUTANEOUS ULTRASOUNOGRAPY VERSUS COMPUTED TOMOGRAPHY IN THE ASSESSMENT OF CANCER LARYNX

Background: The use of ultrasonography as a complementary diagnostic tool to CT in the assessment of cancer larynx has always been underestimated due to the anatomical obstacles in the form of thyroid cartilage calcification yet specific anatomic sites with proper technique implementation raised the sensitivity and specificity of the sonographic results and presented it as a trustable screening tool taking advantage of its additional dynamic criteria. Aim of work: To evaluate the usefulness of ultrasonography versus Computed Tomography in assessing cancer larynx. Patients and Methods: 46 patients with histopathologically proven laryngeal carcinoma were enrolled after exclusion of 5 patients from surgery. A comparative assessment was made between the detection rate of localization and sensitivity, specificity, PPV, NPV and accuracy of pre-therapeutic ultrasonography compared to CT with post operative pathology as a standard reference.Results: Most of the patents were males [47(92.2%)/51] and aged > 60 years [25(49%)/51]. The detection rate was highest in glottic lesions being the same in both ultrasonography and CT [32 (96.9%)/33] with a sensitivity and specificity of 90.9% and 84.6% versus 93.9% and 92.3% in each modality respectively. (p=0.000). The specificity, sensitivity, PPV, NPV and accuracy results of invasion of the intra-laryngeal structures were comparable for both modalities: U/S and CT in detection of thyroid cartilage invasion being 88.8%, 89.3%, 84.2%, 92.5% and 89.1% for U/S versus 88.8%, 96.4%,94.1%, 93.1 and 93.4% for CT, paraglottic fat infiltration being 90.3%, 86.7%, 93.3%, 81.2% and 89.1% for U/S versus 93.5%, 93.3%, 96.7%, 87.5% and 94.4% for CT and anterior commissure infiltration being 88.5%, 90%, 92%, 85.7% and 89.1% for U/S versus 96.2%, 100%, 100%, 95.2% and 97.8% for CT. Conclusion: Ultrasonography could be used as a valuable supplementary imaging method to CT and laryngoscopy in the assessment of laryngeal carcinoma, even in male adults with some calcifications of the thyroid cartilage.