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Application of 4D-CT Scanning in Differential Diagnosis of Arytenoid Subluxation and Vocal Fold Paralysis

  • Author Footnotes
    # Jin-an Wang and Xinlin Xu have contributed equally to the work.
    Jin-an Wang
    Footnotes
    # Jin-an Wang and Xinlin Xu have contributed equally to the work.
    Affiliations
    Department of Radiology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian Province, China
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  • Author Footnotes
    # Jin-an Wang and Xinlin Xu have contributed equally to the work.
    Xinlin Xu
    Footnotes
    # Jin-an Wang and Xinlin Xu have contributed equally to the work.
    Affiliations
    Department of Otolaryngology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian Province, China
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  • Yanli Ma
    Affiliations
    Department of Otolaryngology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian Province, China
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  • Peiyun Zhuang
    Affiliations
    Department of Otolaryngology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian Province, China
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  • Yong Wang
    Correspondence
    Address correspondence and reprint requests to Yong Wang, MD, Department of Radiology, Zhongshan Hospital, Xiamen University, No. 201 South Hubin Road, Xiamen, Fujian Province, 361004, China.
    Affiliations
    Department of Radiology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian Province, China
    Search for articles by this author
  • Author Footnotes
    # Jin-an Wang and Xinlin Xu have contributed equally to the work.
Published:October 15, 2020DOI:https://doi.org/10.1016/j.jvoice.2020.09.027

      Summary

      Objective

      To differentiate arytenoid subluxation and vocal fold paralysis by CT cine mode scanning combined with three-dimensional (3D) reconstruction image.

      Methods

      Seventy-six patients with suspected vocal fold dyskinesia were collected. All patients were examined being asked to inhale deeply and then make "Yi" sound continuously during CT scanning with cine mode. The optimal maximum opening and minimum closing phases of glottis were selected and 3D reconstruction images were performed. The length of vocal fold, the width of glottis, and the subglottal convergence angle, anteversion angle, elevation angle, valgus angle, and varus angle of cricoarytenoid joints were measured. Vocal fold deformation was divided into three types: type I, type II, and type III. Kappa test was used to compare the consistency between CT diagnosis and clinical diagnosis. Single-factor analysis of variance was used to analyze the statistical differences among arytenoid subluxation, vocal fold paralysis, and normal vocal fold.

      Results

      There was high consistency between CT diagnosis and clinical diagnosis (k = 0.731, P < 0.05), as well as significant differences in the opening width of glottis between type I and type III, the valgus and varus angles of cricoarytenoid joints between type I and type II or type III, and the subglottal convergence angles among the three types of vocal fold deformation.

      Conclusions

      CT scanning with cine mode combined with 3D reconstruction can display the changes of larynx structures in vocal fold dyskinesia, and can be used for the differential diagnosis of arytenoid cartilage subluxation and vocal fold paralysis.

      Key Words

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