Autor(es): Cunha, B ; Lancini, D ; Rondi, P ; Ravanelli, M ; Maroldi, R ; Paderno, A ; Zigliani, G ; Bertotto, I ; Piazza, C ; Farina, D
Data: 2023
Identificador Persistente: http://hdl.handle.net/10400.17/4962
Origem: Repositório do Centro Hospitalar de Lisboa Central, EPE
Assunto(s): HSJ NRAD; Humans; Carbon Dioxide; Lasers; Laryngeal Neoplasms*; Microsurgery; Magnetic Resonance Spectroscopy; Neoplasm Recurrence, Local
Objective: Laryngeal chondritis (LC) is a rare complication of carbon dioxide transoral laser microsurgery (CO2 TOLMS) for laryngeal tumours and can pose a diagnostic challenge. Its magnetic resonance (MR) features have not been previously described. This study aims to characterise a cohort of patients who developed LC after CO2 TOLMS and describe its clinical and MR findings. Methods: Clinical records and MR images of all patients presenting with LC after CO2 TOLMS between 2008 and 2022 were reviewed. Results: Seven patients were analysed. Timing of LC diagnosis ranged from 1 to 8 months after CO2 TOLMS. Four patients were symptomatic. Abnormal endoscopic findings included suspected tumour recurrence in 4 patients. MR documented focal or extensive signal changes involving the thyroid lamina and para-laryngeal space with T2 hyperintensity, T1 hypointensity and intense contrast enhancement (n = 7), and minimally reduced mean apparent diffusion coefficient (ADC) values (1.0-1.5 x 10-3 mm2/s) (n = 6). A favourable clinical outcome was achieved in all patients. Conclusions: LC after CO2 TOLMS has a distinctive MR pattern. When tumour recurrence cannot be confidently excluded based on imaging, antibiotic therapy, close clinical and radiological follow-up and/or biopsy are recommended.
