{Reference Type}: Journal Article
{Title}: Utility of Ultrahigh-Resolution Computed Tomography for Laryngeal Reconstructive Surgery.
{Author}: Kise N;Hirakawa H;Aniya S;Ooshiro T;Kondo S;Tomoda A;Oyakawa Y;Kiyuna A;Suzuki M;
{Journal}: Laryngoscope
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 19
{Factor}: 2.97
{DOI}: 10.1002/lary.31577
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.<BR><B>METHODS: </B>Level 3 (case-control study) Laryngoscope, 2024.