Asymmetry of the vocal folds in patients with vocal fold immobility.
OBJECTIVE
To measure the vocal fold length (VFL) during inspiration and phonation and to determine the vertical difference of the vocal folds during phonation in patients with unilateral vocal fold immobility.


METHODS
Prospective study.


METHODS
University hospital. Patients Thirty patients with unilateral vocal fold immobility.


METHODS
Each subject was asked to sustain the vowel /a/ and, after a short rest, to inhale slowly. The region over the larynx was scanned using multislice helical computed tomography during each maneuver; 3-dimensional endoscopic, coronal, and sagittal images were produced.


METHODS
The VFLs on each side and the vertical differences between the vocal folds were calculated.


RESULTS
The inspiratory VFL on both sides was significantly longer in men than in women. It was significantly longer on the healthy side than on the immobile side in both groups. On the healthy side, the inspiratory VFL was significantly longer than the phonatory VFL in men, but there was no significant difference in women. In contrast, on the immobile side, the phonatory VFL was significantly longer than the inspiratory VFL in women, but there was no significant difference in men. The VFLs of the healthy and immobile sides varied in tandem. The immobile vocal fold was situated lower than the healthy vocal fold during phonation in 3 patients.


CONCLUSIONS
Multislice helical computed tomography is a novel method to measure the VFL and the vertical level difference between the vocal folds. Application of this method might facilitate further understanding of laryngeal behavior in patients with unilateral vocal fold immobility.
Oyamada
Yukio
Y
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan.
Yumoto
Eiji
E
Nakano
Koji
K
Goto
Hidenori
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D001239:Inhalation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010699:Phonation / Q000502:physiology; D011446:Prospective Studies; D015203:Reproducibility of Results; D036542:Tomography, Spiral Computed; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014827:Vocal Cords / Q000000981:diagnostic imaging* / Q000503:physiopathology