Department of Otorhinolaryngology, Tokyo Medical University Hospital, 6-7-1, Shinjuku-ku, Nishi Shinjuku, Tokyo, 160-0023, Japan.
Eur Arch Otorhinolaryngol. 2012 Feb;269(2):565-70. doi: 10.1007/s00405-011-1787-4. Epub 2011 Oct 5.
In a previous study of patients with unilateral vocal-fold paralysis (UVFP), three-dimensional computed tomography (3DCT) revealed passive movement during phonation, with the arytenoid cartilage on the paralyzed side pushed to the unaffected side and deviated upwards. The present work compares the 3DCT findings with those obtained by 2-dimensional endoscopy to visualize the vertical passive movement of the arytenoid cartilage. The study population consisted of 23 patients with UVFP and two with laryngeal deviation but normal movement of the vocal folds. Two endoscopic findings represented cranial deviation during phonation: posterior deviation of the arytenoid hump and lateral deviation of the muscular process. These two findings were classified into four grades, ranging from 0 (normal) to 3 (severe). Cranial displacement detected by 3DCT was also classified into four grades. Significant correlations were found between the 3DCT-determined grade of cranial displacement of the arytenoid cartilage and the grade assigned based on the two endoscopic findings. Moreover, lateral deviation of the muscular process was more significantly correlated with 3DCT grade than with endoscopic grade. Thus, endoscopic findings may be useful in the diagnosis of vocal-fold paralysis, and passive lateral deviation of the muscular process as an indicator of UVFP.
在一项针对单侧声带麻痹（UVFP）患者的先前研究中，三维计算机断层扫描（3DCT）显示在发音期间存在被动运动，麻痹侧的杓状软骨被推向未受影响的一侧并向上偏斜。本研究将 3DCT 结果与通过二维内镜观察杓状软骨的垂直被动运动的结果进行比较。研究人群包括 23 例单侧声带麻痹患者和 2 例声带正常运动但出现喉偏斜的患者。内镜检查发现两种与发音时颅侧偏斜有关的表现：杓状软骨结节后向偏斜和肌突侧方偏斜。这两种表现分为四个等级，从 0（正常）到 3（严重）。3DCT 检测到的杓状软骨颅侧移位的程度也分为四个等级。3DCT 确定的杓状软骨颅侧移位程度与基于两种内镜表现的分级之间存在显著相关性。此外，肌突侧方偏斜与 3DCT 分级的相关性比与内镜分级的相关性更显著。因此，内镜检查结果可能有助于声带麻痹的诊断，而肌突的被动侧方偏斜可作为单侧声带麻痹的指标。
