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(2) 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(2) TOLMS and describe its clinical and MR findings. METHODS: Clinical records and MR images of all patients presenting with LC after CO(2) TOLMS between 2008 and 2022 were reviewed. RESULTS: Seven patients were analysed. Timing of LC diagnosis ranged from 1 to 8 months after CO(2) 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(-3) mm(2)/s) (n = 6). A favourable clinical outcome was achieved in all patients. CONCLUSIONS: LC after CO(2) 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.