S192 – 3D Diagnosis of Vocalizing Larynx Using Cone Beam CT
Objectives Cone beam computed tomography (CBCT) was developed for the office-based quick and precise 3D visualization of maxillofacial region. CBCT requires scanning time of less than 10 seconds and provides isotropic 3D image with high resolution. In this study, we examined the potential role of CBCT as a tool for 3-dimensional evaluation of the glottal insufficiency. Methods CBCT was performed in 2 normal controls and in 14 patients with unilateral vocal fold paralysis (13 cases) or paresis (1 case). Laryngeal CBCT images were taken in the resting state and during phonation. Furthermore, preoperative and postoperative images were evaluated to assess the impact of phonosurgeries in 5 cases. Results CBCT of the vocalizing vocal fold was successfully performed in all the cases, producing clear coronal images. During phonation, no remarkable differences in levels between the paralyzed and normal vocal folds were observed in 10 cases, proving the 2-dimensional glottal gap (2D cases). On the other hand, the levels of paralyzed vocal folds stayed higher during phonation compared to the normal side in 4 cases, proving the 3-dimensional glottal gap (3D cases). 4 of the 2D cases had injection laryngoplasty and 1 of the 3D cases had arytenoid adduction procedure to correct their glottal gaps. Postoperative CBCT images verified the successful correction of these gaps. Conclusions Our study proved the feasibility of CBCT for 3D evaluation of vocalizing larynx. This quick and easy system may have an informative role to suggest the proper phonosurgical procedure for glottic insufficiency.