甲状披裂筋麻痺患者における高速度デジタル撮像検査所見についての検討

抄録

Thyroarytenoid muscle paralysis (TAMP), one of partial vocal fold paralysis, is often considered in the differential diagnosis of breathy hoarseness. Laryngeal electromyography (LEMG) is necessary for definitive diagnosis of this disease, however, this is a difficult and invasive procedure. Therefore, regular flexible fiberoptic endoscopy and laryngeal stroboscopy are often used clinically for the diagnosis of TAMP.

The vibratory characteristics on high-speed digital imaging (HSDI) were evaluated in 4 patients diagnosed as having unilateral TAMP by LEMG. Three cases were male and one was female, and all patients developed TAMP after surgery.

In all the 4 patients with TAMP, amplitude/phase asymmetry of vibrations between the bilateral vocal folds were observed on HSDI. Furthermore, in three patients, phase asymmetry was observed between the anterior and posterior portion (posterior-to-anterior opening type) of the diseased glottis, due to decrease of the TA muscle tension. This unique finding, that is, phase asymmetry between the anterior and posterior portion of the diseased glottis, may be a characteristic finding of TAMP on HSDI.