Laryngeal Cancer: Diagnostic Tests

Mandatory medical device diagnostics.

  • Laryngoscopy (indirect laryngoscopy) – at initial diagnosis.
  • Laryngeal stroboscopy – at initial diagnosis (assessment of vocal fold function during phonation: regular stroboscopic examinations allow early detection of infiltrative vocal fold processes. Mucosal changes that infiltrate the vocal fold muscles lead to a stroboscopic (phonatory) arrest. If this stagnation persists for 2-3 weeks, the indication for microlaryngoscopic trial excision is given).
  • Microlaryngoscopy (MLS; endoscopy/mirror examination of the larynx; MLS is performed under general anesthesia (general anesthesia)) – microlaryngoscopic and histological clarification (fine tissue examination), preferably as an excisional biopsy (form of tissue removal (biopsy), in which a suspicious finding or tissue change is completely removed for examination purposes) in suspected diagnosis of laryngeal carcinoma; only in the case of larger tumors, only a biopsy should be performed.
  • Panendoscopy (endoscopy of the entire upper airway and esophagus) – to exclude a synchronous second carcinoma.
  • Computed tomography (CT; sectional imaging procedure (X-ray images taken from different directions with computer-based analysis)) of the neck.
    • Patients with laryngeal carcinoma:
      • Carcinoma of the vocal folds with restriction of movement or fixation.
      • Carcinomas of the anterior commissure with extension to the supra- and/or subglottic region
      • Carcinomas of the supraglottis except when localized at the free margin of the epiglottis
      • Carcinomas with subglottic extension.
    • To determine the extent of disease (infiltration, metastasis, or staging); unlike stroboscopy, the value of imaging techniques in early stages of laryngeal carcinoma is low
    • For follow-up
  • Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e. without X-rays)) of the neck.
    • Patients with laryngeal carcinoma:
      • Carcinoma of the vocal folds with restriction of movement or fixation.
      • Carcinomas of the anterior commissure with extension to the supra- and/or subglottic region
      • Carcinomas of the supraglottis except when localized at the free margin of the epiglottis
      • Carcinomas with subglottic extension.
    • To determine the extent of disease (infiltration, metastasis, or staging); unlike stroboscopy, the value of imaging techniques in early stages of laryngeal carcinoma is low
    • For follow-up
  • CT of the thorax and abdomen or a CT of the thorax and abdominal ultrasonography (ultrasound of the abdominal organs) – in advanced metastatic (≥ N2) laryngeal carcinoma to exclude distant metastasis (metastasis/daughter tumor that is not close to the primary tumor and the regional lymph node system)
  • Positron emission tomography/computed tomography (PET-CT; combined nuclear medicine (PET) and radiology (CT) imaging procedure in which the distribution pattern of radioactive substances (tracers) can be localized very precisely with the aid of cross-sectional imaging) – for follow-up care
  • Sonography (ultrasound examination) – to determine the status of the lymph nodes and for follow-up.