CT findings in chondroradionecrosis of the larynx

PURPOSE: Our goal was to describe the CT findings before and after radiation therapy in a series of patients with laryngeal chondroradionecrosis. METHODS: The CT studies obtained before and after radiation therapy in nine patients with the diagnosis of laryngeal chondroradionecrosis were reviewed retrospectively. RESULTS: CT scans revealed abnormalities in all patients. A variable degree of laryngeal soft-tissue swelling was seen in eight of the patients. In four patients, cartilaginous abnormalities were visible initially, and appeared in three of four other patients who had further follow-up CT studies. Six patients had involvement of the thyroid cartilage; collapse of the thyroid cartilage was seen in two cases and gas bubbles were visible adjacent to the thyroid cartilage in three cases. Four patients with involvement of the thyroid cartilage eventually underwent total laryngectomy, and one died suddenly in severe respiratory distress. In all three patients with arytenoidal involvement, anterior dislocation of this cartilage was seen; in two of these patients, the adjacent part of the cricoid cartilage showed some sclerosis. Two patients with arytenoidal necrosis (both with cricoidal sclerosis) kept a functional larynx. In one case, cricoidal sclerosis was seen in association with lysis of the thyroid cartilage. CONCLUSION: The CT appearance of laryngeal chondroradionecrosis is nonspecific, but the diagnosis can be strongly suggested in cases of sloughing of the arytenoid cartilage, fragmentation and collapse of the thyroid cartilage, and/or in the presence of gas bubbles around the cartilage.