2D and 3D CT imaging correlated to rigid endoscopy in complex laryngo-tracheal stenoses

Gluecker, Th; Lang, Florian; Bessler, Stephan; Monnier, Ph.; Meuli, Reto; Schnyder, P.; Duvoisin, B

doi:10.1007/s003300000567

Cited by 32 publications

(4 citation statements)

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“…Although some studies focused on benign lesions of the airways, 5,6 others presented VE findings in various malign and benign lesions including malign neoplasms of the upper airways, vocal cord nodules, laryngeal cysts, Reinke's edema, and leukoplakia. 2Y4,7 Common to all these studies, VE provided a good simulation of the OE view of the intraluminal mass when the mass was well projecting into the lumen.…”

Section: Y7mentioning

confidence: 99%

Diagnostic Contribution of Virtual Endoscopy in Diseases of the Upper Airways

et al. 2006

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Purpose: Virtual endoscopy (VE) is a new diagnostic tool that generates 3-dimensional (3D) views of a lumen by exploiting cross-sectional images. The purpose of this study was to evaluate the usefulness of VE as a diagnostic tool in the diseases of the larynx and pharynx. Materials and Methods: Twenty-two patients with a mean age of 57 years were included in the study. The patients underwent larynx examination, optical endoscopy (OE), and computed tomography (CT) of the larynx. Later, VE was produced from the CT images. Results: Eight patients had larynx carcinoma, a 5-yearold patient had a laryngeal web, a 43-year-old man had fish bone stuck in his submucosal layer, 10 patients were normal, and the remaining two patients were under follow-up for treated nasopharynx carcinoma and had no evidence for recurrence. VE showed the laryngeal tumor in seven patients and the laryngeal web in one patient, but failed to show a plaquelike tumor and the fishbone within the submucosa. Conclusions: Our findings suggest that VE is a useful and complimentary method of 3D imaging in the diseases compromising the laryngeal lumen. Furthermore, it may be superior to OE in severe stenosis or obstructions where the endoscope cannot be passed through.

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Section: Y7mentioning

confidence: 99%

Diagnostic Contribution of Virtual Endoscopy in Diseases of the Upper Airways

et al. 2006

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“…7 , 8 , 10 , 15 , 16 Besides, with the volumetric data and reconstructions, the area of stenosis can be viewed from different angulations and sides. 17 , 18 Furthermore, this modality can be used when the patient cannot tolerate FFL, allowing the assessment of the airway without the use of general anaesthesia and exposure to associated risks such as trauma to the teeth, the neck and the airway. 8 , 14 On the other hand, VE has multiple limitations described by several studies, including radiation exposure and the inability to identify mucosal irregularities or flat lesions.…”

Section: Discussionmentioning

confidence: 99%

Comparison of diagnostic accuracy of computed tomography virtual endoscopy and flexible fibre-optic laryngoscopy in the evaluation of neck anatomic structures and neoplasms

et al. 2020

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Background and purpose Computed tomography virtual endoscopy (CT-VE) is a non-invasive technique which allows visualisation of intraluminal surfaces by tridimensional reconstruction of air/soft tissues. The aim of this study was to compare the diagnostic accuracy of CT-VE and flexible fibre-optic laryngoscopy (FFL) in identifying normal neck anatomic structures and pharyngeal and laryngeal lesions. Methods Forty-two patients with a history of neck cancer were assessed by two ENT surgeons using FFL and by one neuroradiologist using CT-VE in order to evaluate the visualisation of the epiglottis, vallecula, glossoepiglottic folds, pyriform sinuses, vocal cords and mass pathology. The visualisation of the structures in both modalities was assessed according to the following score: 0 = not visualised, 1 = partial visualisation, 2 = complete and clear visualisation. A weighted kappa coefficient was used to evaluate the inter-observer agreement. McNemar’s test was performed to compare the two diagnostic tests. Results The inter-observer agreement between FFL and CT-VE was fair in the assessment of the vocal cords ( k = 0.341); moderate in the assessment of the glossoepiglottic folds ( k = 0.418), epiglottis ( k = 0.513) and pyriform sinuses ( k = 0.477); and substantial in the assessment of the vallecula ( k = 0.618) and the tumour (0.740). McNemar’s test showed no significant difference between the two tests ( p<0.05). Conclusion CT-VE is a non-invasive technique with a diagnostic accuracy comparable to FFL in terms of visualisation of anatomical structures and pharyngeal and laryngeal lesions.

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“…They are held in place with a heavy suture through the thyrohyoid and cricothyroid membranes. Keels should be left in place for two to four weeks and then removed endoscopically under general anesthetics so that any undesirable granulation tissue can also be removed at the same time (1, 3, 16). To the best of our knowledge, this is the first case report of laryngeal stent aspiration as evidenced by extensive PubMed and English-literature search.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Aspiration of Custom-Made Keel: A Case Report

Sharouny

Omar

2014

Iran Red Crescent Med J

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Introduction:Laryngeal stenosis has various causes and treatment options. Endoscopic resection of the stenotic part with CO2 laser is one of the treatment options of laryngotracheal stenosis. Keels are useful for preventing adhesion formation, restenosis and web formation, which may happen during the later stage. They can be put in place either via the endoscopic approach or through a micro thyroidotomy and are held in place with a heavy suture through cricothyroid and thyrohyoid membranes. They are left in place for two to four weeks, and then removed through the endoscopic approach under general anesthetics.Case Presentation:We report on a case of anterior glottis stenosis with keel aspiration for two weeks, after endoscopic CO2 laser resection of the stenotic section and keel placement. The patient was admitted to our center, where bronchoscopy was performed and the keel was removed. A new custom-made silastic keel was properly placed in raw areas and fixed to the skin with suture through the cricothyroid and thyrohyoid membranes. The keel was removed three weeks later.Conclusions:Endoscopic keel placement should be done with heavy suture through cricothyroid and thyrohyoid membranes. Surgeons should suture the keel to the anterior laryngeal wall with specially designed Lichtenberger’s needle-carriers to prevent complications such as keel aspiration, adhesion formation and imposing a second trip under general anesthetics, which put the patient at increased risk. The false vocal cord microflaps, as biological keels and a relatively new method may replace silastic keel placement in the future.

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2D and 3D CT imaging correlated to rigid endoscopy in complex laryngo-tracheal stenoses

Cited by 32 publications

References 0 publications

Diagnostic Contribution of Virtual Endoscopy in Diseases of the Upper Airways

Diagnostic Contribution of Virtual Endoscopy in Diseases of the Upper Airways

Comparison of diagnostic accuracy of computed tomography virtual endoscopy and flexible fibre-optic laryngoscopy in the evaluation of neck anatomic structures and neoplasms

Iatrogenic Aspiration of Custom-Made Keel: A Case Report

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