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    Dynamic Computed Tomographic Evaluation of Vocal Cord Mobility in Patients With Larynx Cancer
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) Celebi, Irfan; Mahmutoglu, Abdullah S.; Vural, Cetin; Bankaoglu, Mujdat; Caliskan, Kosti C.; Erturk, Sukru M.; Basak, Muzaffer
    Objective: To evaluate the accuracy of dynamic laryngeal computed tomography (DLCT) for the detection of vocal cord mobility in larynx cancer. Methods: Vocal cord mobility of 44 patients (36 men; age range, 49-81 years) with larynx cancer was examined; 13 patients were excluded (owing to poor image quality or bilateral vocal cord involvement), and vocal cord mobility was evaluated for the remaining 31 patients qualitatively and quantitatively with dynamic laryngeal computed tomography during phonation, inspiration, and Valsalva maneuver phase. Results: The mobile cords were laterally positioned in a straight configuration on inspiration phase. Phonation phase images revealed medial displacement with protrusion of the cords (shoulder sign) and ventricular niche (31 patients/42 cords). Fixed cords (13 patients/13 cords) conserved their configuration and location during all phases. The distances of the vocal cords to the midline were measured based on the images obtained during inspiration and Valsalva maneuvers. The mean +/- SD difference between the movement distances of cords measured during each phase was as follows: 6.16 +/- 1.64 mm for the mobile cord (n = 42) and 3.17 +/- 0.78 mm for the impaired cord (n = 7) on the midcoronal plane (P = 0.0001). A comparison between the mean distance values of the mobile, impaired and fixed cords groups revealed significant distance. Conclusions: Dynamic laryngeal computed tomography of the larynx of patients with laryngeal cancer can be used as a supplemental tool to examine cord mobilization for accurate T-staging (particularly for patient laryngoscopy, which is difficult to perform), and can provide additional information to physicians.
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    Using Dynamic Maneuvers in the Computed Tomography/Magnetic Resonance Assessment of Lesions of the Head and Neck
    (ELSEVIER SCIENCE BV, 2013) Celebi, Irfan; Oz, Aysel; Sasani, Mehdi; Bayindir, Petek; Sozen, Esra; Vural, Cetin; Basak, Muzaffer
    Despite advances in technology, the radiologic assessment of certain head and neck lesions may still pose difficulties because of the complex anatomy of this region, the small and mobile structures that this region harbors, and the apposition of mucosal surfaces in the neutral position. Certain maneuvers have been described in the literature to overcome these difficulties. We review the use of the Valsalva and the modified Valsalva maneuver, the puffed-cheek technique, phonation, and inspiration, with possible applications in head and neck imaging.