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Characterization of arytenoid vertical displacement in unilateral vocal fold paralysis by three-dimensional computed tomography.
Eur Arch Otorhinolaryngol. 2009 Jan; 266(1):97-104.EA

Abstract

The paralyzed arytenoid is not immobile and is subjected to passive movement during phonation. If anatomical changes during inspiration and phonation are compared by three-dimensional computed tomography (3D CT), it is possible to observe vertical movement of the paralyzed arytenoid. Our aim was to use 3D CT to examine the characteristics of 3D arytenoid movement in unilateral vocal fold paralysis (UVFP). This is a prospective study. A total of 61 patients (18 females and 43 males) with UVFP who had undergone 3D CT imaging between April 2005 and January 2007 were included. Cricoid and arytenoid cartilage was imaged by 3D CT. We detected the movements of the paralyzed side when comparing inspiration and phonation. The degree of cranial displacement of the paralyzed arytenoids was classified into three grades (I for mild to III for severe). The mean flow rate (MFR) was calculated for each grade. By comparing the MFR of each grade with the normal control group, we determined whether cases would worsen according to grade. Passive gliding movement of the paralyzed arytenoids was found in 90.7% of cases. In all cases, the paralyzed arytenoids were displaced cranially compared to the unaffected side. MFR worsened significantly as the grade became more severe. We believe that the passive gliding movements observed when comparing inspiration and phonation are characteristic of paralysis. Even in mild cases, the paralyzed arytenoids are passively displaced cranially during phonation, and the degree of this displacement is one indicator that can be used to evaluate the severity of UVFP.

Authors+Show Affiliations

Department of Otolaryngology, Tokyo Medical University Hospital, 6-7-1, Shinjuku-ku, Nish Shinjuku, Tokyo, 160-0023, Japan. hiro441741@aa.cyberhome.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18437409

Citation

Hiramatsu, Hiroyuki, et al. "Characterization of Arytenoid Vertical Displacement in Unilateral Vocal Fold Paralysis By Three-dimensional Computed Tomography." European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, vol. 266, no. 1, 2009, pp. 97-104.
Hiramatsu H, Tokashiki R, Nakamura M, et al. Characterization of arytenoid vertical displacement in unilateral vocal fold paralysis by three-dimensional computed tomography. Eur Arch Otorhinolaryngol. 2009;266(1):97-104.
Hiramatsu, H., Tokashiki, R., Nakamura, M., Motohashi, R., Yoshida, T., & Suzuki, M. (2009). Characterization of arytenoid vertical displacement in unilateral vocal fold paralysis by three-dimensional computed tomography. European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 266(1), 97-104. https://doi.org/10.1007/s00405-008-0682-0
Hiramatsu H, et al. Characterization of Arytenoid Vertical Displacement in Unilateral Vocal Fold Paralysis By Three-dimensional Computed Tomography. Eur Arch Otorhinolaryngol. 2009;266(1):97-104. PubMed PMID: 18437409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of arytenoid vertical displacement in unilateral vocal fold paralysis by three-dimensional computed tomography. AU - Hiramatsu,Hiroyuki, AU - Tokashiki,Ryoji, AU - Nakamura,Mari, AU - Motohashi,Rei, AU - Yoshida,Tomoyuki, AU - Suzuki,Mamoru, Y1 - 2008/04/24/ PY - 2008/01/11/received PY - 2008/04/11/accepted PY - 2008/4/26/pubmed PY - 2009/5/6/medline PY - 2008/4/26/entrez SP - 97 EP - 104 JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery JO - Eur Arch Otorhinolaryngol VL - 266 IS - 1 N2 - The paralyzed arytenoid is not immobile and is subjected to passive movement during phonation. If anatomical changes during inspiration and phonation are compared by three-dimensional computed tomography (3D CT), it is possible to observe vertical movement of the paralyzed arytenoid. Our aim was to use 3D CT to examine the characteristics of 3D arytenoid movement in unilateral vocal fold paralysis (UVFP). This is a prospective study. A total of 61 patients (18 females and 43 males) with UVFP who had undergone 3D CT imaging between April 2005 and January 2007 were included. Cricoid and arytenoid cartilage was imaged by 3D CT. We detected the movements of the paralyzed side when comparing inspiration and phonation. The degree of cranial displacement of the paralyzed arytenoids was classified into three grades (I for mild to III for severe). The mean flow rate (MFR) was calculated for each grade. By comparing the MFR of each grade with the normal control group, we determined whether cases would worsen according to grade. Passive gliding movement of the paralyzed arytenoids was found in 90.7% of cases. In all cases, the paralyzed arytenoids were displaced cranially compared to the unaffected side. MFR worsened significantly as the grade became more severe. We believe that the passive gliding movements observed when comparing inspiration and phonation are characteristic of paralysis. Even in mild cases, the paralyzed arytenoids are passively displaced cranially during phonation, and the degree of this displacement is one indicator that can be used to evaluate the severity of UVFP. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/18437409/Characterization_of_arytenoid_vertical_displacement_in_unilateral_vocal_fold_paralysis_by_three_dimensional_computed_tomography_ L2 - https://dx.doi.org/10.1007/s00405-008-0682-0 DB - PRIME DP - Unbound Medicine ER -