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Three-dimensional computed tomography analysis of neoglottis after supracricoid laryngectomy with cricohyoidoepiglottopexy

Published online by Cambridge University Press:  28 October 2011

Y Seino ,
M Nakayama ,
M Okamoto  and
S Hayashi
Y Seino*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
M Nakayama
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
M Okamoto
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
S Hayashi
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
*
Address for correspondence: Dr Yutomo Seino, Department of Otorhinolaryngology-HNS, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 252-0374, Japan Fax: +81 42 778 8441 E-mail: yutomo.s@kitasato-u.ac.jp
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Abstract

Introduction:

Supracricoid laryngectomy with cricohyoidoepiglottopexy is an organ-preserving procedure used to treat laryngeal cancer. However, the post-operative neoglottis tends to be variable in form and difficult to predict.

Methods:

We retrospectively analysed three-dimensional images reconstructed from multidetector-row computed tomography data for 21 patients, assessing arytenoid motion and minimum neoglottic gap cross-sectional area.

Results:

While mean transverse and coronal motion was similar for bilateral and unilateral arytenoids, movement along the sagittal axis was greater for unilateral than bilateral arytenoids. The neoglottic gap during respiration was wider in patients with bilateral arytenoids, but both groups had a similar neoglottic gap during phonation.

Conclusion:

Anterior shifting of the unilateral arytenoid plays an important role in compensating for the inability to achieve neoglottic closure. These two results demonstrate that the unilateral arytenoid alone is capable of achieving sufficient neoglottic narrowing to compensate for the resected arytenoid. Three-dimensional analysis was useful to evaluate the physiological status of the neoglottis after supracricoid laryngectomy with cricohyoidoepiglottopexy.

Keywords

LaryngectomyVoiceComputer Assisted Three-Dimensional ImagingLaryngeal CartilagesArytenoid Cartilage
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 385 - 390
Copyright
Copyright © JLO (1984) Limited 2011

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