A new computed tomography (CT) technology, helical (spiral) CT, allows the entire neck to be imaged in only 30 seconds. Although multiplanar and three-dimensional (3-D) imaging could be performed with conventional CI, the volumetric acquisition provided by helical (spiral) CT allows significantly improved quality and easier reconstruction for more applications. These 3-D models show an airway appearance similar to that obtained with laryngography. Independent review of the 3-D images in 12 patients with lesions by two radiologists and one otolaryngologist was performed to assess: 1) image quality, 2) ability to judge lesion extent, and 3) assistance in understanding the lesion compared to that provided by routine axial scans. Rating scores of 1 to 5 were assigned, with 5 representing the best quality or greatest value. The results showed that both groups scored image qualityequally: 4.7. Lesion extent for the radiologists was 2.6, while the otolaryngologist's ranking was 3.7 (p < .01). In assisting understanding of lesions versus axial scans, radiologists ranked 3-D images 2.1, while the otolaryngologist ranked them 3.7 (p < .01). In summary, 3 -D models provide a complementary imaging technique in understanding upper airway disease.