What is the role of imaging studies in the workup of cricoarytenoid (CA) fixation?

Updated: Jul 27, 2021
  • Author: Paul C Bryson, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Although CT scanning may help in demonstrating arytenoid dislocation or cartilaginous fracture, the extent of ossification of the laryngeal cartilage and the plane and thickness of the sections limit the sensitivity of CT. In patients in whom the arytenoid is not ossified (ie, children, young adults), CT imaging is relatively unrevealing.

Plain radiography of the neck and larynx occasionally reveals evidence of cricoarytenoid (CA) joint pathology. Joint erosion and blurring may demonstrate active arthritis.

A retrospective study by Ravanelli et al reported that in patients with cT3 laryngeal squamous cell carcinoma (SCC), signal patterns from magnetic resonance imaging (MRI) with surface coils can indicate the etiology of arytenoid fixation. The investigators found that a normal signal pattern and one characterized by T2 hyperintensity, with no diffusion-weighted imaging (DWI) restriction, tend to be associated with arytenoid fixation stemming from mass effect and/or an inflammatory reaction. However, an intermediate T2 signal with DWI restriction strongly suggests arytenoid fixation resulting from neoplastic invasion. [4]


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