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马的喉部的三维模型可用于进行传统的杓状软骨外展测量,并可对模型植入物进行定位,以证明在环杓关节处放置刚性植入物的解剖可行性。

Three-dimensional models of the equine larynx can be used to perform traditional measures of arytenoid abduction and permit the positioning of modeled implants to demonstrate the anatomic feasibility of placing a rigid implant across the cricoarytenoid joint.

机构信息

Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL.

Department of Physiological Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL.

出版信息

Am J Vet Res. 2023 May 13;84(6). doi: 10.2460/ajvr.22.11.0202. Print 2023 Jun 1.

Abstract

OBJECTIVE

To develop 3D models of larynges to compare arytenoid abduction measurements between specimens and models, and to investigate the anatomic feasibility of placing an implant across the cricoarytenoid joint (CAJ) with or without arthrotomy.

SAMPLES

Cadaveric equine larynges (n = 9).

PROCEDURES

Equine larynges underwent sequential CT scans in a neutral position and with 2 arytenoid treatments: bilateral arytenoid abduction (ABD) and bilateral arytenoid abduction after left cricoarytenoid joint arthrotomy (ARTH). Soft tissue, cartilage, and luminal volume 3-dimensional models were generated. Rima glottidis cross-sectional area (CSA) and left-to-right quotient (LRQ) angles were measured on laryngeal specimens and models. Arytenoid translation, articular contact area, and length of modeled implants placed across the CAJ were measured on models. Data were analyzed using paired t test or ANOVA and Tukey's post hoc test or non-parametric equivalents (P < .05).

RESULTS

ARTH CSA was larger for laryngeal specimens than models (P = .0096). There was no difference in all other measures of CSA and LRQ angle between treatment groups or between specimens and models. There was no difference between ABD and ARTH groups for arytenoid cartilage translation, contact area, and implant length. The articular contact area was sufficient for modeled implant placement across the CAJ with a narrow range of implant lengths (17.59 mm to 23.87 mm) across larynges with or without arthrotomy.

CLINICAL RELEVANCE

These results support further investigation of a CT-guided, minimally invasive surgical procedure. Future studies will evaluate the outcomes of the new procedure for technical precision, biomechanical stability, and post-operative success rates for horses with recurrent laryngeal neuropathy (RLN).

摘要

目的

建立喉的 3D 模型,比较标本和模型的杓状软骨外展测量值,并研究在不进行或进行关节切开术的情况下,在环杓关节(CAJ)放置植入物的解剖可行性。

样本

马尸体喉(n = 9)。

程序

马喉在中立位置和 2 种杓状软骨处理下进行连续 CT 扫描:双侧杓状软骨外展(ABD)和左侧环杓关节关节切开术后双侧杓状软骨外展(ARTH)。生成软组织、软骨和管腔容积的 3 维模型。在喉标本和模型上测量声门裂横截面积(CSA)和左右比值(LRQ)角。在模型上测量杓状软骨移位、关节接触面积和放置在 CAJ 上的模型植入物的长度。使用配对 t 检验或方差分析和 Tukey 事后检验或非参数等效物(P <.05)分析数据。

结果

与模型相比,喉标本的 ARTH CSA 更大(P =.0096)。在 CSA 和 LRQ 角的所有其他测量值方面,治疗组之间或标本和模型之间均无差异。ABD 和 ARTH 组之间,杓状软骨软骨移位、接触面积和植入物长度均无差异。在不进行或进行关节切开术的情况下,CAJ 上的关节接触面积足以放置模型植入物,植入物长度范围较窄(17.59 毫米至 23.87 毫米)。

临床意义

这些结果支持进一步研究 CT 引导的微创手术。未来的研究将评估新技术的结果,包括技术精度、生物力学稳定性以及复发性喉神经病(RLN)马的术后成功率。

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