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


CONCLUSIONS
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.
Department of Otorhinolaryngology - Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan. yutomo.s@kitasato-u.ac.jp
Y
Y
Seino
M
M
Nakayama
M
M
Okamoto
S
S
Hayashi
D000368:Aged; D001193:Arytenoid Cartilage / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D003413:Cricoid Cartilage / Q000601:surgery; D005260:Female; D005931:Glottis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome