| Purpose The larynx is both a respiratory organ and an organ of pronunciation.The larynx is composed of cartilage to form a bony frame.There are fibrous ligaments connected between the larynx cartilage and related muscles on the surface.The movement of the vocal cords is mainly done by the movement of the hoop joint.In this study,MSCT images are used to observe the anatomical measurement of laryngeal joint structure in patients with laryngeal cancer and vocal cord paralysis in the state of calm breathing and "yi" sound,and to analyze the application of dynamic imaging in the diagnosis of laryngeal joint movement diseases value.Eliminate other glottal movements with insignificant effects,simplify the movement to make a "yi" sound,obtain better patient cooperation,reduce the number of scans and the amount of radiation,and reduce the workload of research.Methods Using the MSCT in our hospital,the selected patients with laryngeal cancer(39 cases,including 37 males and 2 females)and vocal cord paralysis patients(19 cases,including 15 males and 4 female)are breathing calmly and making "yi" sound.State MSCT scan and 3D reconstruction of the larynx cartilage stent(scan parameter settings: FOV330,matrix 512×512,collimator layer thickness 0.6mm,voltage 120 kv,thread pitch 1mm,tube current150 m A,reconstruction layer thickness 1mm).Through the image post-processing system of our hospital’s radiology department and the minics20.0 software,3D reconstruction of cricoid cartilage and arytenoid cartilage are carried out,and the distance from the vocal cord process to the midline,the distance from the vocal cord process,the distance from the midline to the midline of the vocal cord process,the distance between my process and the dipper are measured respectively.Cartilage and horizontal plane angle,dipper cartilage axial rotation angle,dipper cartilage and cricoid cartilage plane angle,sagittal cartilage rotation angle.The measurement data is analyzed with statistical software SPSS 22.0.Result 1.Vocal cord protrusion to midline distance: For the vocal cord paralysis group: when breathing calmly,it makes differences on both sides(P(27)0.05).In pronunciation,it makes differences on both sides(P(27)0.05).For the posterior 1/3 group of laryngeal cancer invading the vocal cords: it makes no differences on both sides when breathing calmly(P>0.05).In pronunciation,it makes differences on both sides(P(27)0.05).The first 2/3 group of laryngeal cancer invaded the vocal cords:it makes no differences on both sides when breathing calmly(P>0.05).In pronunciation,it makes no differences on both sides(P>0.05).The vocal cord fixation group for laryngeal cancer: When breathing calmly,it makes differences on both sides(P(27)0.05).In pronunciation,it makes no differences on both sides(P>0.05).2.Vocal cord protrusion displacement: For the vocal cord paralysis group:it makes no differences on both sides(P>0.05).For the 1/3 group after laryngeal cancer invaded the vocal cords: it makes no differences on both sides(P>0.05).For the first 2/3 group of laryngeal cancer invaded the vocal cords: it makes no differences on both sides(P>0.05).The laryngeal cancer vocal cord fixation group: it makes differences on both sides(P(27)0.05).3.Muscle process to midline distance: For the vocal cord paralysis group:when breathing calmly,it makes differences on both sides(P(27)0.05).It makes differences on both sides during pronunciation(P(27)0.05).For the posterior 1/3group of laryngeal cancer invading the vocal cords: when breathing calmly,it makes no differences on both sides(P>0.05).In pronunciation,it makes differences on both sides(P(27)0.05).For the first 2/3 group of laryngeal cancer invading the vocal cords: when breathing calmly,it makes no differences on both sides(P>0.05).It makes no differences on both sides during pronunciation(P>0.05).For the vocal cord fixation group of laryngeal cancer: when breathing calmly,it makes differences on both sides(P(27)0.05).It makes no differences on both sides during pronunciation(P>0.05).4.Muscle displacement: For the vocal cord paralysis group: it makes no differences on both sides(P>0.05).For the 1/3 group after laryngeal cancer invaded the vocal cords: it makes no differences on both sides(P>0.05).The first 2/3 group of laryngeal cancer invaded the vocal cords: it makes no differences on both sides(P>0.05).For the laryngeal cancer vocal cord fixation group: it makes differences on both sides(P(27)0.05).5.The angle between the arytenoid cartilage and the horizontal plane: For the vocal cord paralysis group: it makes differences on both sides during calm breathing(P(27)0.05).It makes no differences on both sides during pronunciation(P>0.05).For the 1/3 group after laryngeal cancer invaded the vocal cords: it makes differences on both sides when breathing calmly(P(27)0.05).It makes differences on both sides during pronunciation(P(27)0.05).For the first 2/3 group of laryngeal cancer invading the vocal cords: it makes no differences on both sides during calm breathing(P>0.05).It makes no differences on both sides during pronunciation(P>0.05).For the laryngeal carcinoma vocal cord fixation group: it makes differences on both sides during calm breathing(P(27)0.05).It makes no differences on both sides during pronunciation(P>0.05).6.Axial rotation angle of arytenoid cartilage: For the vocal cord paralysis group: it makes differences on both sides(P(27)0.05).For the 1/3 group after laryngeal cancer invades the vocal cords: it makes differences on both sides(P(27)0.05).For the first 2/3 group of laryngeal cancer invades the vocal cords: it makes no differences on both sides(P>0.05).For the laryngeal cancer vocal cord fixation group: it makes differences on both sides(P(27)0.05).7.Planar angle of arytenoid cartilage and cricoid cartilage: For the vocal cord paralysis group: it makes differences on both sides during calm breathing(P(27)0.05).It makes differences on both sides during pronunciation(P(27)0.05).For the 1/3 group after laryngeal cancer invaded the vocal cords: it makes differences on both sides when breathing calmly(P(27)0.05).It makes differences on both sides during pronunciation(P(27)0.05).For the first 2/3 group of laryngeal cancer invading the vocal cords: it makes no differences on both sides during calm breathing(P>0.05).It makes no differences on both sides during pronunciation(P>0.05).For the laryngeal cancer vocal cord fixation group: it makes differences on both sides when breathing calmly(P(27)0.05).It makes no differences on both sides when pronunciation(P>0.05).8.Sagittal rotation angle of arytenoid cartilage: For the vocal cord paralysis group: it makes differences on both sides(P(27)0.05).For the 1/3 group after laryngeal cancer invades the vocal cords: it makes no differences on both sides(P>0.05).For first 2/3 group of laryngeal cancer invaded the vocal cords: it makes no differences on both sides(P>0.05).For the laryngeal cancer vocal cord fixation group: it makes differences on both sides(P(27)0.05).Conclusion 1.In this experiment,the anatomical measurement of the laryngeal joint structure of the vocal cord paralysis patients in the state of calm breathing and "yi" is measured through the MSCT image,and the corresponding vocal cord motor muscles and their dominance affecting the vocal cord dyskinesia are verified according to the measurement results nerve.2.In this experiment,the anatomical measurement of the laryngeal joint structure of patients with laryngeal cancer in a calm breathing and "yi" state is measured by MSCT images,and the measurement results verified that the tumor mainly invaded the back of the vocal cord 1(14)3 when the vocal cords moved It has an impact,and when the vocal cords move,the rotation angle of the arytenoid cartilage is more sensitive than the displacement of the vocal cords.3.In this study,other glottal movements with insignificant effects are removed,and the exercise is simplified to make a "yi" sound to obtain a better coordination of the patient,and the scan range is not large,reducing the number of scans and the amount of radiation,and reducing the workload of the research.It is possible to appropriately increase the scanning dose to obtain better image resolution and perform three-dimensional reconstruction of the laryngeal joint.4.This study uses MSCT images to finely measure the changes in the anatomical structure of the vocal cord movement,which can distinguish small differences,which is more precise than the electronic laryngoscope,and may provide a new method for clinical auxiliary diagnosis of vocal cord movement disorders. |
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