Laryngeal scar cases are often difficult to treat due to complicated pathogenesis. There is a possibility that anomalies in deep structures that cannot be observed by endoscopy may cause impairments in vocal fold motion or mucosal waves. Therefore, it is necessary to understand not only vocal fold lesions, but also the presence or absence of scars in deep regions, changes in the shape of the laryngeal framework, displacement and movement disorders of arytenoid cartilage.
Using 3DCT, we examined autologous fat injection laryngoplasty cases, laryngeal trauma cases, and cases in which laryngofissure was performed after laryngeal trauma in order to determine the influence that structural anomalies in deep regions have on vocal fold motion or mucosal waves. All cases involved impairments in vocal fold motion or mucosal waves, and the presence of a scarring lesion was suspected.
In the autologous fat injection laryngoplasty cases, vocal fold mucosal waves were impaired as a result of both vocal folds being tense due to overinjection. In the laryngeal trauma cases, fractured cricoid cartilage and dislocated arytenoid cartilage were confirmed at the cricoarytenoid joint. In the post-laryngofissure cases, vocal fold level differences due to unilateral arytenoid dislocation and vertical misalignment of the bilateral thyroid cartilage lamina were confirmed. These anomalies accounted for the impairments in vocal fold motion and mucosal waves.
For treating voice disorders that result from laryngeal scar, it is important to consider structural anomalies in deep regions in addition to regions that can be observed with an endoscope. 3DCT allows visualization of the complex configuration of the larynx, and is thus suited for the evaluation of laryngeal scar cases.
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