Xiamen University Zhongshan Hospital, ENT Department, Xiamen, Fujian, China.
Otolaryngol Head Neck Surg. 2013 Sep;149(3):451-6. doi: 10.1177/0194599813491222. Epub 2013 May 29.
To present a new method of quantifying arytenoid movement during inspiration and determine if it can be used to distinguish arytenoid dislocation from vocal fold paralysis.
Case series with chart review.
Retrospective study conducted in a university laboratory based on university hospital data.
Endoscopic videos from 8 patients with dislocation and 5 patients with vocal fold paralysis diagnosed by electromyography were included. Vector analysis measured cuneiform movement, an indirect measurement of arytenoid movement, during 1 inspiration. Measurements normalized and not normalized to vocal fold length were evaluated. Interrater reliability (2 raters) and intrarater reliability (1 rater performing the analysis twice) were evaluated using intraclass correlation coefficient (ICC) analysis. Raters were blinded to subject group during analysis.
Pixel-valued cuneiform movement was 81.16 ± 25.62 for dislocation and 30.22 ± 23.60 for paralysis (P = .019). Unitless cuneiform movement was 0.58 ± 0.17 for dislocation and 0.24 ± 0.18 for paralysis (P = .030). Interrater ICC was 0.942 for pixel-valued measurements and 0.962 for unitless measurements. Intrarater ICC was 0.909 for pixel-valued measurements and 0.881 for unitless measurements.
Both pixel-valued and unitless measures of arytenoid movement were significantly greater in arytenoid dislocation than vocal fold paralysis. Pixel-valued measurements were included to demonstrate the ability to make quantitative comparisons across subjects without precise knowledge of camera precision, provided position is approximately stable, as each measurement is inherently normalized by vocal tract length. Future studies will apply this new method of evaluating vocal fold immobility disorders on a larger scale and incorporate a more diverse group of etiologies.
提出一种量化吸气时杓状软骨运动的新方法，并确定其是否可用于区分杓状软骨脱位与声带麻痹。
基于大学医院数据的回顾性病例系列和图表回顾研究。
在大学实验室进行的回顾性研究。
纳入了 8 例诊断为脱位和 5 例诊断为声带麻痹的患者的内镜视频。通过矢量分析测量了楔形运动，这是杓状软骨运动的间接测量，在 1 次吸气过程中进行。评估了未归一化和归一化至声带长度的测量值。使用组内相关系数（ICC）分析评估了两位评分者之间的组内可靠性（2 位评分者）和一位评分者（进行两次分析）之间的组内可靠性。评分者在分析过程中对受试者分组保持盲态。
对于脱位，像素值楔形运动为 81.16 ± 25.62，对于麻痹为 30.22 ± 23.60（P =.019）。对于脱位，无单位楔形运动为 0.58 ± 0.17，对于麻痹为 0.24 ± 0.18（P =.030）。像素值测量的组内 ICC 为 0.942，无单位测量的组内 ICC 为 0.962。像素值测量的组内 ICC 为 0.909，无单位测量的组内 ICC 为 0.881。
在杓状软骨脱位中，无论是像素值测量还是无单位测量，杓状软骨运动都明显大于声带麻痹。像素值测量被纳入，以证明在不精确了解摄像机精度的情况下，对受试者进行定量比较的能力，只要位置大致稳定，因为每个测量值都通过声道长度进行了内在归一化。未来的研究将在更大的范围内应用这种评估声带固定障碍的新方法，并纳入更多不同病因的患者。
