Diagnosis of anterior commissure invasion in laryngeal cancer.

The objective of the study is the invasion of anterior commissure (AC) by a laryngeal carcinoma has an oncological importance for the outcome. Detection of invasion is difficult due to particular anatomical features of this region. Therefore, we aimed to investigate the value of different diagnostic modalities for the detection of AC involvement at the patients with laryngeal carcinoma. Retrospective analysis of medical charts in a tertiary referral center. Records of preoperative clinical examination, computerized tomography (CT), peroperative examination and postoperative histopathological examination of 47 patients with laryngeal carcinoma were analyzed. The results of postoperative histopathological examination were accepted as true. Sensitivity, specificity, negative-predictive value, positive-predictive value and accuracy ratios were calculated for each modality. AC involvement was found to be positive in 23 patients according to the postoperative histopathological examination. Peroperative clinical examination was found to be superior to preoperative clinical examination and CT. In conclusion, classical multi-slice CT only on axial planes is not a reliable method to detect the invasion of AC. Preoperative clinical examination by suspension laryngoscopy under general anesthesia has an approximately 30% failure rate. Peroperative examination must not be neglected if possible.