title: Three-dimensional Imaging of High-resolution Computer Tomography of Singers' Larynges-A Pilot Study.
abstract: OBJECTIVE
  Biplanar imaging technique is not sufficient for an exact visualization and evaluation of the laryngeal biomechanics during speaking or singing. The aim of this pilot study was to test a 3D-visualization software MIMICS (Materialize Interactive Medical Image Control System, Materialize, Leuven, Belgium) for visualizing laryngeal cartilages and resonance space of living humans during singing based on high-resolution computed tomography (HRCT) and analyzing the biomechanics thereof.
  
  
  METHODS
  This is a prospective pilot study.
  
  
  METHODS
  A total of 10 professional female singers (five sopranos and five altos) was scanned with HRCT in three singing positions fundamental frequency (ƒo), first octave (ƒo+1 8va) and second octave (ƒo+2 8va).
  
  
  RESULTS
  All relevant laryngeal structures and resonance space could be 3D visualized. Superimposing the different HRCT scans showed an inward rotation and rocking of the arytenoid cartilages from ƒo+1 8va to ƒo+2 8va and a backward tilting of the cricoid cartilage from ƒo+1 8va to ƒo+2 8va. Moreover, we could demonstrate a vocal fold elongation of 13% from ƒo to ƒo+1 8va and an additional elongation from ƒo+1 8va to ƒo+2 8va of 10% in type A cricothyroid joints (CTJ) A and 4% in CTJ's type B/C. There were no significant differences between sopranos and altos in all parameters (length of the glottis, subglottic diameter, distance between anterior commissure and cervical spine, and CTJ distribution).
  
  
  CONCLUSIONS
  This noninvasive 3D-visualization technique with MIMICS allows the anatomical structures and landmarks of the larynx to be analyzed. We believe that this pilot study will serve as a basis for further biomechanical studies on speakers' and singers' larynges.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Vorik
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland.
authors.forename: Fabian
authors.initials: F
authors.lastname: Unteregger
authors.affiliation: Department of Music and Private ENT Practice Schlieren, Zurich University of the Arts, Zurich, Switzerland.
authors.forename: Salome
authors.initials: S
authors.lastname: Zwicky
authors.affiliation: Department of Music and Private ENT Practice Schlieren, Zurich University of the Arts, Zurich, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Schiwowa
authors.affiliation: Institute of Radiology, Limmattal Hospital, Schlieren, Switzerland.
authors.forename: Silke
authors.initials: S
authors.lastname: Potthast
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland. Electronic address: claudio.storck@usb.ch.
authors.forename: Claudio
authors.initials: C
authors.lastname: Storck
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005240:Feasibility Studies; D005260:Female; D005931:Glottis / Q000000981:diagnostic imaging / Q000502:physiology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007817:Laryngeal Cartilages / Q000000981:diagnostic imaging / Q000502:physiology; D007830:Larynx / Q000000981:diagnostic imaging* / Q000502:physiology; D008875:Middle Aged; D010699:Phonation; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D063346:Singing; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014833:Voice Quality
keywords: 3D; Biomechanics; Larynx; MIMICS; Singer