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      Usefulness of three-dimensional computed tomography of the larynx for evaluation of unilateral vocal fold paralysis before and after treatment: technique and clinical applications

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          Abstract

          Laryngoplasty is well-known technique for unilateral vocal fold paralysis (UVFP). However, operation result are sometimes not as good as expected before surgery. Three-dimensional Computed tomography (3DCT) is useful for visualizing complicated intralaryngeal structures. Moreover, 3DCT is suited for analyzing the movement of the vocal fold and arytenoid cartilage because the technique is based on actual data from live patients. We have been used 3DCT of the Larynx for evaluation of UVFP before and after treatment. We uncovered some new findings about UVFP and reasons of unsatisfactory outcomes after operation. Technique and clinical applications of 3DCT for UVFP are outlined in this paper.

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          Most cited references12

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          Thyroplasty type I (lateral compression) for dysphonia due to vocal cord paralysis or atrophy.

          Based on the experimental results of thyroplasty, thyroplasty type I which aims at medical shifting the vocal cord was performed on 8 patients with dysphonia, 6 with vocal cord paralysis and 2 with vocal cord atrophy. The surgery was conducted on either in- or out-patient basis and local anesthesia was used. Usually, a rectangular incision was made on the thyroid cartilage at the level of the vocal cord, and the fragmemt was depressed inward. A cartilage piece taken from the opposite side was used as a wedge, if necessary, to enhance the effect of lateral compression of the vocal cord. The voice after surgery was generally satisfactory, except in one case of traumatic vocal cord paralysis. Complications such as stridor or dyspnea were nil. As surgical intervention inside the thyroid cartilage is minimal, fine and reliable adjustment of depression is possible during the surgery.
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            The mechanics of the cricoarytenoid joint.

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              Three-dimensional computerized tomography in the evaluation of laryngeal injury.

              A comparison of diagnostic information obtained from the physical examination, conventional two-dimensional axial computerized tomography scanning (2-D CT), and three-dimensional display computerized tomography (3-D CT) was performed in five patients sustaining laryngeal trauma. Four patients had laryngeal fractures and one patient had an incompletely ossified thyroid cartilage (normal variant) simulating a fracture by 2-D CT. Three-dimensional display computerized tomography was found superior to conventional 2-D CT in assessing the presence and nature of the laryngeal injuries while correctly identifying the anatomic variant.
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                Author and article information

                Contributors
                hiro441741@aa.cyberhome.ne.jp
                Journal
                Eur Arch Otorhinolaryngol
                European Archives of Oto-Rhino-Laryngology
                Springer-Verlag (Berlin/Heidelberg )
                0937-4477
                1434-4726
                10 November 2007
                June 2008
                : 265
                : 6
                : 725-730
                Affiliations
                Department of Otolaryngology, Tokyo Medical University Hospital, 6-7-1, Shinjuku-ku, Nishishinjuku, Tokyo, 160-0023 Japan
                Article
                514
                10.1007/s00405-007-0514-7
                2358940
                17994299
                a5ce255a-fa05-4c48-b0d3-29dcb9765521
                © Springer-Verlag 2007
                History
                : 18 March 2007
                : 18 October 2007
                Categories
                Short Communication
                Custom metadata
                © Springer-Verlag 2008

                Otolaryngology
                unilateral vocal fold paralysis,three-dimensional computed tomography,thyroplasty

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