Poster électronique

Surveillance post-radique des cancers pharyngo-laryngés par scanner cervical
F. Cenoui, R. Latib, L. Jroundi, I. Chami, MN. Boujida - Rabat - Maroc
Congrès 2010
Résumé
Objectifs
Évaluer la place du scanner par rapport à d'autres techniques d'imagerie dans la surveillance post-thérapeutique des cancers pharyngo-laryngés. Présenter la séméiologie scanographique des aspects habituels, des complications et des récidives néoplasiques après traitement du cancer du pharyngo-larynx.
Matériels et méthodes
Patients atteints de cancer du pharyngo-larynx recrutés dans notre formation. Les patients ont bénéficés d'un scanner cervical dans le cadre de leur suivi pot-radique et/ou postopératoire. Il est réalisé en mode hélicoïdal après injection de produit de contraste avec des reconstructions coronales et sagittales.
Résultats
Le cancer du pharyngo-larynx est traité par irradiation et chirurgie, qui sont sources de remaniements tissulaires importants : œdème, fibrose, troubles salivaires, fibrose pulmonaire et l'épaississement pharyngolaryngé. Les complications post-opératoires sont : nécrose des tissus mous, de l'os, et du cartilage ; fibrose menant à des désordres fonctionnels ; artériopathie ; myélopathie tardive et paralysie des nerfs crâniens. Les récidives peuvent être locales, ganglionnaires ou à distance (métastases). L'interprétation scanographique est souvent difficile, en particulier pour distinguer des remaniements tissulaires locaux des récidives.
Conclusion
Le scanner cervical est la meilleure technique pour la surveillance post-thérapeutique du cancer du pharyngo-larynx, notamment après radiothérapie. C'est un complément indispensable de l'examen clinique et endoscopique lors du suivi post-thérapeutique. La sémiologie scanographique est importante à connaître pour différencier les remaniemnts inflammatoires d'une éventuelle récidive.
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2016-09-06 10.12 :
MN

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