Seino Y, Nakayama M, Okamoto M, Hayashi S
Department of Otorhinolaryngology - Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
J Laryngol Otol. 2012 Apr;126(4):385-90. doi: 10.1017/S002221511100257X. Epub 2011 Oct 28.
Supracricoid laryngectomy with cricohyoidoepiglottopexy is an organ-preserving procedure used to treat laryngeal cancer. However, the post-operative neoglottis tends to be variable in form and difficult to predict.
We retrospectively analysed three-dimensional images reconstructed from multidetector-row computed tomography data for 21 patients, assessing arytenoid motion and minimum neoglottic gap cross-sectional area.
While mean transverse and coronal motion was similar for bilateral and unilateral arytenoids, movement along the sagittal axis was greater for unilateral than bilateral arytenoids. The neoglottic gap during respiration was wider in patients with bilateral arytenoids, but both groups had a similar neoglottic gap during phonation.
Anterior shifting of the unilateral arytenoid plays an important role in compensating for the inability to achieve neoglottic closure. These two results demonstrate that the unilateral arytenoid alone is capable of achieving sufficient neoglottic narrowing to compensate for the resected arytenoid. Three-dimensional analysis was useful to evaluate the physiological status of the neoglottis after supracricoid laryngectomy with cricohyoidoepiglottopexy.
环状软骨上喉切除术联合环舌会厌固定术是一种用于治疗喉癌的器官保留手术。然而，术后新声门的形态往往多变且难以预测。
我们回顾性分析了21例患者的多排螺旋计算机断层扫描数据重建的三维图像，评估杓状软骨运动和最小新声门间隙横截面积。
双侧和单侧杓状软骨的平均横向和冠状面运动相似，但单侧杓状软骨沿矢状轴的运动大于双侧杓状软骨。双侧杓状软骨患者呼吸时的新声门间隙更宽，但两组在发声时的新声门间隙相似。
单侧杓状软骨向前移位在补偿新声门无法闭合方面起重要作用。这两个结果表明，仅单侧杓状软骨就能实现足够的新声门变窄以补偿切除的杓状软骨。三维分析有助于评估环状软骨上喉切除术联合环舌会厌固定术后新声门的生理状态。
