Computer-based analysis with three-dimensional imaging constructed from fine-slice computed tomography scan of supracricoid laryngectomy with cricohyoidoepiglottopexy: report of two cases

Abstract

Supracricoid laryngectomy with cricohyoidoepiglottopexy is an organ-preserving surgical technique used to treat laryngeal cancer. This procedure resects the vocal folds; however, it is unclear how the sound source and airway morphology are involved in phonation through the post-operative neoglottis. Multidetector helical computed tomography scanning was performed on two patients who had undergone supracricoid laryngectomy with cricohyoidoepiglottopexy. The cricoid and arytenoid cartilages and the airway were visualised using three-dimensional images. The mobility of the arytenoid cartilages was well preserved in the one patient with bilateral arytenoids, and in the other patient with only one arytenoid remaining. Two types of airway configuration were observed during phonation: one patient had a single stream airway, while the other had a combination of several streams. In the patient with only one arytenoid remaining, the preserved arytenoid tended to be rotated excessively inward. Therefore, phonation may have also occurred in various airways followed by mucosal vibration, which may be a sound source.