OpenHealth Q&A

Seeking Clarity on My CT Scan Findings

Hello everyone, I'm a 29-year-old female, and I recently underwent a CT scan to assist in diagnosing my subglottic stenosis. I am scheduled for surgery next week to address this issue, but I came across several other findings in my scan results that I need help interpreting. I have included the full report below and highlighted the areas I'm particularly interested in understanding better. I welcome any insights you might have regarding other pertinent details. Thank you! As a bit of background, my stenosis is considered idiopathic at this stage; however, this hasn’t been definitively confirmed. It was detected during a visit to an urgent care facility. I do not currently have a primary care physician. **CT SCAN WITH CONTRAST OF THE NECK** **CLINICAL NOTES:** Inspiratory stridor was observed, prompting the assessment for subglottic stenosis. **TECHNIQUE:** A multidetector CT of the neck was conducted using IV contrast, with reconstructions performed in both sagittal and coronal views. **FINDINGS:** The scan reveals an eccentric, circumferential thickening in the subglottic airway measuring 7 mm in length and a maximum thickness of 6 mm, contributing to a focal stenosis located 1.9 cm beneath the true vocal cords. The remaining trachea and major bronchi appear normal. The nasopharynx, oropharynx, hypopharynx, larynx, base of the tongue, vallecula, and aryepiglottic folds are all normal. However, I noticed that the left piriform sinus is obliterated. **What does this imply? Is it referring to my left side or the technician's?** Additionally, there is a detectable absence or severe atrophy of the right submandibular gland. **Can someone explain this further?** The left submandibular gland and both parotid glands are otherwise normal, except for a couple of nodules measuring 5-6 mm in the superficial aspect of the left parotid gland. The thyroid gland shows mild diffuse enlargement with heterogeneous density, suggesting a multinodular goiter. An accessory thyroid tissue, or pyramidal lobe, measuring 1 x 1.4 x 1.6 cm, is located along the anterior side of the trachea in a right paramedian position. There are multiple enlarged lymph nodes throughout the neck, with the largest being in the upper jugular chain, measuring 8 mm in the short axis, although none are enlarged to the imaging criteria's standards. The bilateral carotid arteries and internal jugular veins are free from obstruction. The visible brain parenchyma, both eye sockets, and the paranasal sinuses appear normal. A minor finding of nasal septal deviation towards the right side was noted incidentally. The upper regions of the lungs are normal as well. **Another finding indicates a reversal of the typical cervical lordotic curvature. Does this mean that my neck is misaligned?** **IMPRESSIONS:** 1. Evidence of subglottic stenosis located 1.9 cm beneath the true vocal cords as detailed above. 2. Presence of multiple reactive lymph nodes in the neck, all under a centimeter in size. 3. Absence or severe atrophy of the right submandibular gland alongside a few nonspecific nodules in the superficial lobe of the left parotid gland that could signify reactive lymph nodes. An ultrasound of the left parotid gland is advisable. 4. The thyroid gland shows mild diffuse enlargement with heterogeneous density, with a high likelihood of multinodular goiter. A thyroid ultrasound is recommended for further assessment.

Answers (1)

3/22/2025, 12:31:14 AM

OpenHealth AI

It sounds like you're experiencing a lot of information from your CT scan report, especially given your upcoming surgery for subglottic stenosis. It’s perfectly understandable to seek clarity on your findings. Let’s break down your concerns and address each point clearly.

Key Insights from Your CT Scan

1. Subglottic Stenosis:

   • You have identified a narrowing in the airway below the vocal cords. This is the primary focus of your surgery next week.

2. Left Piriform Sinus Obliteration:

   • This refers to an abnormality where the left piriform sinus, a space near the throat, is non-visible or blocked. Generally, “left” would refer to your left side, not the technician's, meaning it’s specific to your anatomy. This could be related to inflammation or previous medical history.

3. Atrophy of Right Submandibular Gland:

   • The absence or severe shrinkage of this gland may indicate previous damage or inflammation. This could influence saliva production and function.

4. Thyroid Findings:

   • The report indicates a multinodular goiter, meaning multiple areas of enlargement in your thyroid gland. It’s not necessarily alarming, but the recommendation for a thyroid ultrasound is important to further evaluate these nodules.

5. Cervical Lordotic Curvature Reversal:

   • This means that instead of the normal curve in your neck, there is a straightening or reversal, which might suggest muscle tension or other issues. It's termed "misalignment" but is often correctable with physical therapy or exercises.

Next Steps

1. Confirm with Your Surgeon:

   • Discuss these findings in detail with your surgeon prior to your surgery. They can provide explanations tailored to your individual case and address any potential implications.

2. Thyroid Ultrasound:

   • Schedule this ultrasound as recommended. It will help in assessing the nature of the nodules and the overall condition of your thyroid.

3. Consider a Medical Evaluation of Your Neck:

   • A consultation with a specialist (such as an ENT or a physical therapist) can help understand the implications of the cervical lordotic curvature and manage any discomfort associated with it.

4. Monitor Symptoms:

   • Keep an eye on any changes in symptoms related to the submandibular gland or your thyroid. Report these during your upcoming consultations.

5. Seek Regular Follow-up:

   • Since you mentioned not having a primary care physician, it may be beneficial to establish care. This will help you manage ongoing concerns and have a dedicated resource for your health.

Empathy and Reassurance

I understand that processing this amount of medical information can be overwhelming, especially with surgery on the horizon. It’s okay to have questions and to seek clarity. Remember, each of these findings can provide the healthcare team with valuable insights to tailor your care effectively. If you have more questions or need additional clarification, feel free to ask!