Presentation
History of an adenoid cystic carcinoma of the larynx treated with total laryngectomy. She had a transesophageal voice prosthesis 5 years ago. Presents for dysphagia. CT to rule out tumor recurrence.
Patient Data
total laryngectomy with a transesophageal voice prosthesis is noted in situ
dilated and air-filled esophagus with a moderate amount of gas within the stomach and small bowel
there is no mass or nodular thickening suggestive of local recurrence in the surgical site
there is no lymphadenopathy
no esophageal stricture
no hiatus hernia
there is an enhancing left-sided frontotemporal extra-axial mass, in keeping with a meningioma
Case Discussion
There is no local recurrence or esophageal stricture explaining the dysphagia. However, swallowing difficulties may be caused by the esophageal flange of the voice prosthesis that may interrupt bolus flow. It can also contribute to residue accumulation on the prosthesis resulting in dysphagia 1.
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