Hiramatsu Hiroyuki, Tokashiki Ryoji, Yamaguchi Hiroya, Suzuki Mamoru, Ono Hidenori
Department of Otolaryngology, Tokyo Medical University, Tokyo, Japan.
Acta Otolaryngol. 2006 May;126(5):515-20. doi: 10.1080/00016480500406760.
The three-dimensional prototype model was useful for planning of laryngeal framework surgery.
To discuss the usefulness of a three-dimensional laryngeal model for laryngeal framework surgery.
A three-dimensional laryngeal model was created based on the postoperative helical computed tomography (CT) data of the larynx (case 1) which underwent lateral cricoarytenoid muscle (LCA) pull surgery. LCA pull surgery is a kind of arytenoid adduction for unilateral vocal cord paralysis. A three-dimensional model of case 1 larynx was prototyped using a selective laser sintering method. In case 1, the patient's voice did not improve after LCA pull surgery. The three-dimensional model revealed that the original surgical procedure was not appropriate to obtain optimal arytenoid adduction. According to the analysis of this three-dimensional model, we changed the surgical approach and performed this new refined LCA pull surgery on another patient with unilateral vocal cord paralysis (case 2).
We were able to pull LCA precisely in case 2. Three-dimensional CT of case 2 after refined LCA pull surgery allowed the correct pulling of LCA and complete adduction of arytenoid. The postoperative voice improved remarkably.
三维原型模型有助于喉框架手术的规划。
探讨三维喉模型在喉框架手术中的实用性。
基于接受环杓侧肌（LCA）牵拉手术的喉部术后螺旋计算机断层扫描（CT）数据（病例1）创建三维喉模型。LCA牵拉手术是一种用于单侧声带麻痹的杓状软骨内收术。采用选择性激光烧结法制作病例1喉部的三维模型。在病例1中，LCA牵拉手术后患者声音未改善。三维模型显示，原手术操作无法实现最佳的杓状软骨内收。根据该三维模型的分析，我们改变了手术方法，并对另一名单侧声带麻痹患者（病例2）实施了这种新的改良LCA牵拉手术。
在病例2中我们能够精确牵拉LCA。改良LCA牵拉手术后病例2的三维CT显示LCA牵拉正确且杓状软骨完全内收。术后声音明显改善。
