Gilbert R J, Daftary S, Woo P, Seltzer S, Shapshay S M, Weisskoff R M
Massachusetts General Hospital and Harvard Medical School, Nuclear Magnetic Resonance Center, Department of Radiology, Charlestown, MA 02114, USA.
Laryngoscope. 1996 May;106(5 Pt 1):568-72. doi: 10.1097/00005537-199605000-00009.
Abnormalities of vocal fold closure during deglutition predispose to aspiration due to impairment of airway protection. Conventional assessment of deglutitive vocal fold motion with laryngoscopy does not permit visualization through a complete adduction-abduction cycle. We determined spatiotemporal patterns of deglutitive vocal fold adduction through echo-planar magnetic resonance imaging in 15 normal volunteers and 6 patients with vocal fold paralysis. In normal volunteers, deglutitive vocal fold adduction was synchronized with laryngeal elevation, with complete vocal fold closure at the apex. Patients with unilateral vocal fold paralysis demonstrated reduced elevation and medial movement of the involved vocal fold. At maximal laryngeal elevation the uninvolved vocal fold attained a position superior to the paralyzed fold, resulting in level differences and an interglottic gap. Patients with bilateral vocal fold paralysis demonstrated reduced elevation and medial movement of both vocal folds. These findings indicate that normal and abnormal patterns of vocal fold displacement can be distinguished noninvasively through the use of echo-planar imaging.
吞咽期间声带闭合异常会因气道保护功能受损而导致误吸。通过喉镜对吞咽时声带运动进行的传统评估无法在整个内收 - 外展周期中实现可视化。我们通过回波平面磁共振成像确定了15名正常志愿者和6名声带麻痹患者吞咽时声带内收的时空模式。在正常志愿者中，吞咽时声带内收与喉部抬高同步，在顶点处声带完全闭合。单侧声带麻痹患者受累声带的抬高和向内侧运动减少。在喉部最大抬高时，未受累声带达到高于麻痹声带的位置，导致水平差异和声门间间隙。双侧声带麻痹患者双侧声带的抬高和向内侧运动均减少。这些发现表明，通过使用回波平面成像可以无创地区分声带移位的正常和异常模式。
