Abstract：
OBJECTIVE: Unilateral vocal fold paralysis (UVFP) presents as incomplete glottal closure and leads to breathy hoarseness. Various treatments, including laryngeal framework surgery (type 1 thyroplasty [TP1] and arytenoid adduction [AA]), have been devised to correct this condition. Ultrahigh-resolution computed tomography (U-HRCT) allows detailed three-dimensional imaging of the larynx, which aids our understanding of vocal fold motion disorders. This study assessed whether U-HRCT is beneficial for correct diagnosis and surgical planning.
METHODS: The participants were 26 UVFP patients who underwent laryngeal framework surgery (TP1 and/or AA). U-HRCT was used to measure the vocal fold volume (VFV) and level difference (LD). The need to combine AA with TP1 to obtain satisfactory surgical outcomes was evaluated by U-HRCT and various voice function tests.
RESULTS: VFV was smaller in paralyzed folds than in unaffected folds. LD correlated strongly with voice parameters and showed high intra-rater and inter-rater reliability. The surgical outcome of the laryngeal framework surgery performed was judged to be excellent for improving voice function. Comparison of LD between the TP1 group and TP1 + AA group indicated that LD is an excellent parameter to determine the need to combine AA with TP1.
CONCLUSIONS: These findings underscore the value of preoperative U-HRCT, especially LD, in surgical decision-making and afford insights for optimal phonosurgery and individualized intervention. Patients with LD >1.0 mm may benefit from thyroplasty with AA.
METHODS: Level 3 (case-control study) Laryngoscope, 2024.
METHODS: The participants were 26 UVFP patients who underwent laryngeal framework surgery (TP1 and/or AA). U-HRCT was used to measure the vocal fold volume (VFV) and level difference (LD). The need to combine AA with TP1 to obtain satisfactory surgical outcomes was evaluated by U-HRCT and various voice function tests.
RESULTS: VFV was smaller in paralyzed folds than in unaffected folds. LD correlated strongly with voice parameters and showed high intra-rater and inter-rater reliability. The surgical outcome of the laryngeal framework surgery performed was judged to be excellent for improving voice function. Comparison of LD between the TP1 group and TP1 + AA group indicated that LD is an excellent parameter to determine the need to combine AA with TP1.
CONCLUSIONS: These findings underscore the value of preoperative U-HRCT, especially LD, in surgical decision-making and afford insights for optimal phonosurgery and individualized intervention. Patients with LD >1.0 mm may benefit from thyroplasty with AA.
METHODS: Level 3 (case-control study) Laryngoscope, 2024.
摘要：
目的：单侧声带麻痹（UVFP）表现为声门闭合不全，并导致呼吸性声音嘶哑。各种治疗方法,包括喉框架手术（1型甲状腺成形术[TP1]和Arytenoid内收[AA]），已经被设计来纠正这种情况。超高分辨率计算机断层扫描（U-HRCT）可以对喉部进行详细的三维成像，这有助于我们对声带运动障碍的理解。这项研究评估了U-HRCT是否有利于正确诊断和手术计划。
方法：参与者是26例接受喉框架手术（TP1和/或AA）的UVFP患者。使用U-HRCT测量声带体积（VFV）和水平差（LD）。通过U-HRCT和各种语音功能测试评估了将AA与TP1结合以获得满意的手术结果的必要性。
结果：瘫痪褶皱的VFV小于未受影响的褶皱。LD与语音参数密切相关，并显示出较高的评分者内部和评分者之间的可靠性。喉框架手术的手术结果被认为是改善语音功能的极好。TP1组和TP1+AA组之间LD的比较表明,LD是确定AA与TP1组合需要的极好参数。
结论：这些发现强调了术前U-HRCT的价值，尤其是LD,在手术决策中，为最佳语音手术和个性化干预提供见解。LD>1.0mm的患者可从AA甲状腺成形术中获益。
方法：三级（病例对照研究）喉镜，2024.
方法：参与者是26例接受喉框架手术（TP1和/或AA）的UVFP患者。使用U-HRCT测量声带体积（VFV）和水平差（LD）。通过U-HRCT和各种语音功能测试评估了将AA与TP1结合以获得满意的手术结果的必要性。
结果：瘫痪褶皱的VFV小于未受影响的褶皱。LD与语音参数密切相关，并显示出较高的评分者内部和评分者之间的可靠性。喉框架手术的手术结果被认为是改善语音功能的极好。TP1组和TP1+AA组之间LD的比较表明,LD是确定AA与TP1组合需要的极好参数。
结论：这些发现强调了术前U-HRCT的价值，尤其是LD,在手术决策中，为最佳语音手术和个性化干预提供见解。LD>1.0mm的患者可从AA甲状腺成形术中获益。
方法：三级（病例对照研究）喉镜，2024.
