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Unilateral cricothyroid contraction and glottic configuration

G E Woodson1, M P Murry, V Schweizer

  • 1Department of Otolaryngology, University of Tennessee, Memphis 38163, USA.

Journal of Voice : Official Journal of the Voice Foundation
|October 8, 1998
PubMed
Summary

Unilateral cricothyroid muscle (CT) paralysis diagnosis through physical exam is unreliable. CT muscle contraction causes minimal glottic changes, suggesting current diagnostic methods need re-evaluation for accuracy.

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Area of Science:

  • Laryngology
  • Anatomy
  • Physiology

Background:

  • Clinical diagnosis of unilateral cricothyroid muscle (CT) paralysis relies on physical examination findings.
  • Observed signs like glottic rotation and vocal fold displacement are inconsistently reported, leading to diagnostic controversy.

Purpose of the Study:

  • To investigate the three-dimensional effects of cricothyroid muscle contraction on glottic configuration.
  • To evaluate the validity of physical examination signs used to diagnose unilateral CT paralysis.

Main Methods:

  • Computerized tomography (CT) scans were performed on cadaver larynges.
  • Simulated unilateral CT muscle contraction was induced.
  • Radiopaque markers were used to quantify changes in glottic dimensions and vocal fold positions.

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Main Results:

  • Unilateral CT contraction resulted in a minimal posterior glottic rotation (<1 mm).
  • Both membranous vocal folds showed equal length increases.
  • No significant adduction of vocal processes or alteration in their vertical level was observed.

Conclusions:

  • Clinically apparent changes in glottic configuration due to unilateral CT contraction are minimal.
  • Physical examination findings are insufficient for reliably diagnosing unilateral CT paralysis.
  • Current diagnostic criteria for CT paralysis require reassessment based on objective biomechanical data.