4 methods of X-ray examination for laryngeal cancer

X-ray examination can assist laryngoscopy and other examinations to determine the location, size, shape and cartilage condition of laryngeal cancer. There are four main ways to perform X-ray examination of the larynx:

1. Anteroposterior tomography

Generally, the film is taken at 1, 1.5, 2, and 2.5 cm from the skin of the front neck, and after calm breathing, stopping breathing, making high and low sounds, etc. It can show the vestibule, ventricular zone, laryngeal ventricle, vocal cords, subglottis and pyriform sinus, and sometimes it can also show whether the thyroid cartilage is damaged. However, it is difficult to distinguish inflammatory edema, and smaller lesions are easily missed.

2. Lateral plain film (neck cartilage tissue)

The location and extension of the tumor can be observed, which is of reference value for epiglottic cancer, involvement of the pre-epiglottic space, and subglottic cancer. If cancerous tissue invades, the density increases and the shadow becomes irregular. The epiglottic angle is the angle formed by the root of the epiglottis and the vocal cords. This angle disappears in the case of tumor or inflammation.

3. Laryngography

The use of contrast media for intra-laryngeal examination can make up for the deficiencies of the above examinations. First, the surface of the oropharyngeal mucosa is anesthetized, and then the patient is asked to open his mouth and breathe calmly. The contrast agent (iodized oil or barium jelly, etc., about 5 ml) is slowly dripped onto the root of the tongue. The contrast agent is then inhaled into the laryngeal cavity with the airflow. Using anteroposterior and lateral photography, smaller lesions such as mucosal disorder or niche shadows can be seen. Patients with breathing difficulties are prohibited from using this method.

4. Oral barium contrast

Observe the pharynx and esophageal entrance to determine whether there is any extralaryngeal invasion.