術後輪状甲状間部分喉頭切除術における新しい喉頭の術後CTおよび機能的分析

To compare postoperative CT images of different supracricoid partial laryngectomy procedures and to analyze the formation of a new laryngeal.

Observation and retrospective study.

Imaging data of 16 patients with supracricoid partial laryngectomy surgery were collected before and 6 months after different supracricoid partial laryngectomy surgeries. Parameters of larynx CT images were read and measured by three senior otolaryngologists at different layers. Function analysis of the new larynx was mainly focused on voice and swallowing. Two-way analysis of variance was employed to analyze the course data. Spearman correlation analysis was performed to evaluate the relationships between imaging parameters and mPAS score, as well as between imaging parameters and GARBS scales.

In cricohyoidopexy and cricohyoidoepiglottopexy, the body of the hyoid, the residual arytenoid cartilage, and part of the cricoid dorsal plate could be visualized at the same layer. In Tucker procedure, the first display layer of the free edge of the epiglottis was significantly lower than that before operation. The new glottis is shown at the arytenoid layer, most of which is irregular. When compared with the Tucker group, the cricohyoidopexy and cricohyoidoepiglottopexy groups showed a statistical difference in the postoperative distance between the hyoid bone and cricoid cartilage respectively (p < 0.001). The sagittal distance of the new laryngeal cavity increased in the cricohyoidoepiglottopexy and Tucker groups after surgery when compared with the cricohyoidopexy group (p < 0.01). The voice recovery function of cricohyoidopexy patients was better than that of the other two groups, while the three groups had different degrees of swallowing function recovery.

All supracricoid partial laryngectomy procedures showed varying degrees of shortening of the new laryngeal body. The shape of the new laryngeal cavity at the narrowest point was different, but none of them affected respiration and pronunciation. Patients could acquire voice and swallowing recovery in all types of SCPL. It is necessary to evaluate postoperative CT images combined with function analysis to make a better understanding of new larynx structure and function in patients.