The larynx in 3 dimensions: A digital anatomical model derived from radiographic imaging, refined with peer-reviewed literature, and optimized with medical illustration

Abstract

ObjectivesDevelopment of an anatomically accurate three-dimensional (3D) digital model of the human larynx derived from published literature and radiographic imaging. Materials and MethodsThe laryngeal framework was segmented from a computed tomography (CT) angiogram of a healthy 29-year-old female. Data derived from published anatomical studies were compiled to provide additional anatomical detail to each structure. Anatomical details beyond the resolution of the imaging study or which could not be elucidated from the study were refined according to descriptions in the anatomic literature. The 3D model was refined by the medical illustrator, and its mesh was reformatted to optimize online viewing and manipulation. ResultsDue to the small size of the laryngeal muscles, there was no attempt to segment these muscles using radiographic imaging. All intrinsic laryngeal muscles were generated de novo, as were the superior laryngeal nerve and recurrent laryngeal nerve. CT imaging was utilized to generate meshes of the hyoid bone, epiglottis, thyroid cartilage, cricoid cartilage, and thyrohyoid membrane. Additionally, the airway space was segmented to provide size and spatial location to the vallecula, false vocal folds, true vocal folds, piriform sinus, subglottis, and a scaffold for the mucosa. These meshes were processed to limit radiographic artifact and serve as a foundation for the construction of the remainder of the laryngeal anatomy. The model was uploaded to a 3D repository, which can be accessed here (https://shorturl.at/nJPYZ). ConclusionThe larynx is a highly specialized organ essential for speech, swallowing, and airway protection. This study describes a digital 3D model of the larynx, created by combining radiographic imaging with critical review of anatomic literature. Utilizing the expertise of neuroradiology, laryngeal surgery, and medical illustration, we highlight surgically-relevant anatomic relationships and important aspects to consider during laryngeal surgery.