Xu Xinlin, Zhuang Peiyun, Wilson Azure, Jiang Jack J
Division of Otolaryngology, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China.
Division of Otolaryngology, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China.
J Voice. 2021 Mar;35(2):328.e23-328.e28. doi: 10.1016/j.jvoice.2019.09.010. Epub 2019 Oct 22.
Previous studies of subjects with unilateral vocal fold paralysis (UVFP) as observed in a positron emission tomography-computed tomography (PET-CT) examination have demonstrated false positive results in the contralateral cricoarytenoid, in which the metabolism may be higher. This area may also be the site of contralateral compensatory movement in these patients. In this study, we compared the adduction speed of the contralateral vocal folds in patients with UVFP and in healthy subjects as measured by the stroboscopic laryngoscope frame rate. This study aimed to explore the contralateral compensatory movement of the vocal folds in subjects with UVFP.
(1) We collected visual data from 14 patients with UVFP and 14 healthy subjects through a stroboscopic laryngoscope. These subjects were divided into a vocal fold paralysis group and a control group, and we analyzed the excessive adduction of the contralateral vocal folds in the vocal fold paralysis group by examining vocal fold movement speed (pixels/s) as featured in a stroboscopic laryngoscope video. (2) We analyzed the uptake of 18-FDG in the posterior vocal fold from positron emission tomography-computed tomography imaging from four subjects with UVFP and 12 healthy subjects. An independent sample t test and a χ test were used to compare data.
Four subjects with UVFP had a higher metabolic rate in the contralateral cricoarytenoid joints, with a significant difference between the two groups, P < 0.05. Fifty percent of the cases of contralateral adduction of the vocal folds in the subjects with UVFP adducted past the midline, with a significant difference between the two groups, P < 0.05. The contralateral adduction of the vocal folds in subjects with UVFP had shorter video frames and higher adduction speed than the control group, and the difference was statistically significant, P < 0.05. There were fewer vocal fold abduction video frames and higher abduction speed of the healthy side of the vocal fold in subjects with UVFP than the control group, but there was no statistically significant difference, P > 0.05.
Subjects with UVFP exhibited faster adduction compensation in the contralateral vocal folds, and the contralateral cricoarytenoid joint's metabolism in subjects with UVFP was higher. These data may help clarify the diagnostic criteria for laryngeal nerve damage.
以往对单侧声带麻痹（UVFP）患者进行正电子发射断层扫描-计算机断层扫描（PET-CT）检查的研究表明，在对侧环杓关节存在假阳性结果，其代谢可能更高。该区域也可能是这些患者对侧代偿运动的部位。在本研究中，我们通过频闪喉镜帧率比较了UVFP患者和健康受试者对侧声带的内收速度。本研究旨在探讨UVFP患者声带的对侧代偿运动。
（1）我们通过频闪喉镜收集了14例UVFP患者和14名健康受试者的视觉数据。这些受试者被分为声带麻痹组和对照组，我们通过检查频闪喉镜视频中的声带运动速度（像素/秒）来分析声带麻痹组对侧声带的过度内收情况。（2）我们分析了4例UVFP患者和12名健康受试者的正电子发射断层扫描-计算机断层扫描成像中声带后部18-FDG的摄取情况。采用独立样本t检验和χ检验比较数据。
4例UVFP患者对侧环杓关节代谢率较高，两组间差异有统计学意义，P<0.05。UVFP患者中50%的对侧声带内收病例内收超过中线，两组间差异有统计学意义，P<0.05。UVFP患者对侧声带内收的视频帧数比对照组短，内收速度比对照组高，差异有统计学意义，P<0.05。UVFP患者声带健康侧的外展视频帧数比对照组少，外展速度比对照组高，但差异无统计学意义，P>0.05。
UVFP患者对侧声带表现出更快的内收代偿，且UVFP患者对侧环杓关节代谢更高。这些数据可能有助于明确喉神经损伤的诊断标准。
