Thyroplasty in the 3D Modeling Era: Unveiling a New View of the Paralyzed Paraglottis

This study aims to demonstrate the use of computed tomography (CT) imaging to create three-dimensional (3D) models of the paralyzed paraglottis. In doing so, we aim to highlight the parameters that may inform the potential application of this technology to thyroplasty.

This is a retrospective chart review involving adult patients diagnosed with unilateral vocal fold paralysis.

The paraglottic space in both the paralyzed and nonparalyzed sides of adult patients with a known unilateral vocal fold paralysis was 3D modeled using the Brainlab modeling software. The resulting templates were examined to evaluate height asymmetry, and a two-tailed t-test was employed to compare volumes between the two sides.

A total of 13 patients with unilateral vocal fold paralysis were identified. Of the 13 patients, 11 demonstrated a smaller paraglottic space on the paralyzed side, with a mean volume difference of 0.18 cm³ (P = 0.0002) as compared to the innervated side. Of 13, 2 patients with paralyzed vocal folds demonstrated height asymmetry at the level of the glottis. In both instances, the paralyzed vocal fold was found to be lower than the innervated side. There was no correlation between the duration of dysphonia and the volume difference between the hemilarynges.

Our study highlights the enhanced anatomical understanding gained through 3D modeling of the paraglottic space, shedding light on height disparities at the glottic level. Notably, significant volume differences were identified between paralyzed and nonparalyzed hemilarynges. We anticipate that 3D modeling will evolve into a pivotal adjunct in thyroplasty planning, providing substantial preoperative, intraoperative, and postoperative benefits to both patients and surgeons.

STUDY-21-00805.