[Evaluation of the usefulness of ultrasonic examination of the pre-epiglottic space in patients with laryngeal carcinoma].

The subject of the paper was to assess the usefulness of ultrasound examination of preepiglottic space (Fig. 1) in laryngeal carcinoma. Importance of oncological state of HTE space for the choice of treatment was presented. On the basis of 73 patients having laryngeal cancers with different location and progression (Tab. 1) USG, CT imaging and postoperative histopathological investigation were compared. USG investigation of HTE space was performed with ultrasonograph SSA-250 A (Toshiba) at the frequency of transducer 7.5 MHz. In this paper, the method of USG investigation of preepiglottic space was presented. CT examination of HTE space was performed with GE CT Max-640. On the basis of examinations in a group of 16 healthy persons, characteristics of USG image of normal HTE space was established (Fig. 2). That provided a point of reference involving the assessment of USG image of HTE space in patients with laryngeal cancer (Fig. 3). Results of USG, CT (Fig. 4, Fig. 5) and postoperative histopathological examinations were compared. In 86% of cases agreement between USG and histopathological examinations was noted as was between USG and CT. Results of assessment of USG investigation were: sensitivity 90%, specificity 78%, efficiency 86%. Attention was focused on emphatic predisposition of cancer localized on subhyoid part of epiglottis to penetrate into HTE space. Among the cases with this localization of cancer, in 80% neoplastic infiltration was observed in histopathological investigation of HTE space. In this paper causes of false results were analysed. In USG 6 cases were false positive and 3 false negative. In CT 7 cases were false positive and 2 false negative. Reasons of difficulties in interpretation were: advanced laryngeal carcinoma, short and thick neck, changes in neck spine. Established results have shown that USG investigation of preepiglottic space is valuable method and very useful in preoperative diagnosis in laryngeal cancer. It properly helps to assess oncological state of HTE space. This method makes it possible to find even minor changes in HTE space (0.5 cm). It should be here added that the method is easily applicable, reproducible, and in comparison with CT much cheaper and safe with regard to health.