Age-Related Changes In The Cricoarytenoid Unit: A Postmortem Computed Tomography And Histopathology Study
IFOSTANBUL 2026 I XXIII. World Congress of Otorhinolaryngology Head and Neck Surgery, İstanbul, Türkiye, 9 - 13 Eylül 2026, ss.1-2, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Basıldığı Şehir: İstanbul
- Basıldığı Ülke: Türkiye
- Sayfa Sayıları: ss.1-2
- Marmara Üniversitesi Adresli: Evet
Özet
Background & Aim
Preservation of at least one functional cricoarytenoid unit is a prerequisite for open partial horizontal laryngectomy, and advanced age often counts against candidacy. Whether the unit deteriorates structurally with age is unknown, and radiological ageing findings have never been histopathologically validated. We hypothesised that age causes histopathologically demonstrable degeneration and that age-related computed tomography (CT) findings have histopathological counterparts.
Material & Methods
Cross-sectional ex vivo postmortem study, Council of Forensic Medicine, Istanbul. Eighty-two consecutive larynges without laryngeal disease, trauma, surgery, radiotherapy or intubation were studied (66 male, 16 female; mean age 56.6 ± 15.6 years, range 31–95). Each larynx underwent high-resolution CT after formalin fixation, then histopathology of both joints and the posterior and lateral cricoarytenoid muscles. Outcomes were CT calcification appearance, surface irregularity/subchondral cysts, joint space width and muscle attenuation, graded independently by two radiologists, plus histopathological inflammation, fibrosis and calcification (0–3). Independent variables were age (continuous) and sex. Analyses comprised sex-adjusted Firth penalized logistic regression, Spearman correlation, Cohen kappa, intraclass correlation, Bland-Altman analysis and Benjamini-Hochberg correction. No primary endpoint was pre-specified; all results are exploratory.
Results
The only age-related CT finding reproduced by both radiologists was the appearance of cricoarytenoid joint calcification (OR 1.63 per 10 years; 95% CI 1.17–2.38; p=0.003), with predicted prevalence increasing from 44% at age 35 to 90% at age 85. No histopathological variable showed a significant association with age. Although CT suggested joint calcification in approximately 70% of cases, histopathological calcification was present in only 8.5% of right and 3.7% of left joints. Independently of age, increasing histopathological fibrosis of the posterior cricoarytenoid muscle was associated with higher CT muscle density in a dose-response pattern (rho=0.290; p=0.008). Cricoarytenoid joint-space width was not associated with age.
Conclusions
No clear age-related histopathological structural deterioration of the cricoarytenoid unit was demonstrated. CT-detected joint calcification became more frequent with age but often lacked a histopathological correlate, suggesting that chronological age and isolated radiologic calcification should not be used alone as indicators of structural impairment. The correlation between posterior cricoarytenoid muscle fibrosis and CT density also suggests that CT may provide a non-invasive marker of muscle fibrosis.
Keywords
Cricoarytenoid joint; Computed tomography; Histopathology; Aging; Larynx; Postmortem study