Magnetic resonance diagnosis of laryngeal chondritis after transoral laser microsurgery for laryngeal cancer.

OBJECTIVE

Laryngeal chondritis (LC) is a rare complication of carbon dioxide transoral laser microsurgery (CO 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 CO TOLMS and describe its clinical and MR findings.

METHODS

Clinical records and MR images of all patients presenting with LC after CO TOLMS between 2008 and 2022 were reviewed.

RESULTS

Seven patients were analysed. Timing of LC diagnosis ranged from 1 to 8 months after CO 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 mm/s) (n = 6). A favourable clinical outcome was achieved in all patients.

CONCLUSIONS

LC after CO 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.