Desuter Gauthier, Mertens Benjamin, Delchambre Alain, van Lith-Bijl Julie, van Benthem Peter Paul, Sjögren Elisabeth
Otolaryngology, Head & Neck Surgery Department, Voice & Swallowing Clinic, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Otolaryngology, Head & Neck Surgery Department, LUMC, University of Leiden, Leiden, the Netherlands.
Med Devices (Auckl). 2017 Jul 5;10:149-155. doi: 10.2147/MDER.S136561. eCollection 2017.
Glottic leakage during phonation is a direct consequence of unilateral vocal fold (VF) paralysis. This air leakage can be in the horizontal plane and in the vertical plane. Presently, there is no easily applicable medical device allowing noninvasive, office-based measurement of the relative vertical position of the VFs. The larynx ruler (LR) is a laser-based measuring device that could meet the previously stated need, using a flexible endoscope. This study represents a proof of concept regarding the use of the LR in assessing VF relative positions in the vertical plane.
One fresh male human cadaver larynx, free of neurologic and anatomic disease, was explored with the LR system through the operative channel of a flexible gastroenterology video-endoscope. The tip of the video-endoscope was located in the laryngeal vestibule. The right crico-arytenoid joint was posteriorly disarticulated. Tilting of the VF was obtained by pulling or pushing the arytenoid cartilage with a mosquito forceps fixed to the stump of the previously sectioned superior tip of the posterior crico-arytenoid muscle allowing anterior and posterior tilting of the arytenoid cartilage in order to induce an elevation or a depression of the VF process. Ten "push" and ten "pull" sessions were performed. The distance from the tip of the video-endoscope to each illuminated pixel of the laser beam was recorded. The level difference between the left and right VFs was measured for each recording.
Data provided by the LR were consistently in accordance with the movements applied on the VFs. The accuracy of 0.2 mm of the LR is compatible with the envisioned applications for the human larynx.
The LR system represents a feasible technique to evaluate respective vertical position of VFs in the human larynx. Technical limitations were identified that will require improvements before experimental use on human beings.
发声时声门漏气是单侧声带麻痹的直接后果。这种漏气可发生在水平面和垂直面。目前，尚无易于应用的医疗设备可在门诊进行无创测量声带在垂直面的相对位置。喉尺（LR）是一种基于激光的测量设备，可通过柔性内窥镜满足上述需求。本研究是关于使用喉尺评估声带在垂直面相对位置的概念验证。
使用喉尺系统通过柔性胃肠视频内窥镜的操作通道对一具无神经和解剖疾病的新鲜男性尸体喉进行研究。视频内窥镜的尖端位于喉前庭。右环杓关节后方脱位。通过用固定在后环杓肌先前切断的上尖端残端的蚊式镊子牵拉或推压杓状软骨来实现声带倾斜，从而使杓状软骨前后倾斜，以引起声带突的抬高或降低。进行了10次“推”和10次“拉”操作。记录视频内窥镜尖端到激光束每个照明像素的距离。对每次记录测量左右声带之间的水平差异。
喉尺提供的数据与施加在声带上的运动一致。喉尺0.2毫米的精度与人类喉部的预期应用相匹配。
喉尺系统是评估人类喉部声带各自垂直位置的一种可行技术。已确定技术限制，在对人类进行实验性使用之前需要改进。
