Ossification Of Thyroid Cartilage Research Articles

Age estimation from endochondral ossification pattern of thyroid cartilage in the population of Punjab

Objective: The present study aims at studying the ossification of thyroid cartilage and to compare it with age of the individual. Methods: The study was conducted in 300 samples of thyroid cartilage collected during autopsy in the department of Forensic medicine in a tertiary care hospital. Each thyroid cartilage is divided in to thirteen anatomical area and ossification in each defined area was studied through gross and cut section features and classified as ossified and not ossified areas. The samples were grouped in to seven groups of age and ossification features were compared between the age groups. Results: On analysing the ossification pattern of thyroid cartilage in thirteen defined anatomical areas and comparing it with the age, a peculiar sequence of ossification was noted, and it was also observed that frequency of ossification increases significantly with increasing age groups. Conclusion: Ossification of thyroid cartilage helps in establishing the age of individual and it can be categorised to an age group of ten years.

Investigation of the Position and Angle of the Vocal Fold Projected onto the Thyroid Cartilage.

To perform laryngeal framework surgery for unilateral vocal fold paralysis and obtain favorable voice improvement, it is necessary to accurately determine the vocal fold and arytenoid cartilage positions. Thus, the position and angle of the paralyzed vocal folds and arytenoid cartilage projected onto the affected thyroid plate were measured using computed tomography (CT) before and after surgery. Forty-six male patients with thyroid cartilage ossification observed on preoperative CT and vocal fold paralysis were included. Using Adobe Illustrator®, the thyroid plate on the affected side was reconstructed from the continuous images of the sagittal section of the CT examination during participant's quiet breathing (reconstructed affected thyroid plate [RATP]). The anterior commissure mean position was slightly cranial to the midpoint of the thyroid cartilage midline. The paralyzed vocal fold angle was not parallel to the baseline. The average unaffected vocal fold angle during vocalization projected onto the affected thyroid plate was 13.83°, which differed significantly from the average paralyzed vocal fold angle before surgery (19.05°). However, no significant difference was observed in comparison with the average angle of the paralyzed vocal fold after arytenoid adduction. The average distance from the inferior notch of the affected side thyroid cartilage to the affected arytenoid cartilage was 16.7 mm. By understanding the positional relationship between the thyroid cartilage plate and internal structure from preoperative CT images, more effective surgery can be performed according to individual differences. IV Laryngoscope, 134:4088-4094, 2024.

Review of Thyroid Cartilage Compression of the Vertebral Artery

Thyroid cartilage compression of the Vertebral Artery (VA) has been implicated as a rare cause of Rotational Vertebral Artery Occlusion (RVAO). 10 cases have been reported in the literature. This has a higher tendency to affect males and younger patients than other forms of stroke. Patients present with multiple episodes prior to diagnosis. Radiologic studies prove crucial for confirming this condition. An aberrant VA course appears to be a necessary factor. All cases suffer from right side VA compression by the superior thyroid cornu. Conservative therapy with antiplatelet treatment is employed commonly. Most patients have definitive treatment with surgical resection of the right superior thyroid cornu. Theories proposed for these characteristics include VA dominance, structural variability in the thyroid cartilage between genders and also variable thyroid cartilage ossification. Given these findings, we propose the term “thyro-vertebral artery syndrome” for this condition.

Assessment of thyroid cartilage ossification pattern in cancer patients: A suggestion of active ossification by tumor progression.

Ossified cartilage is much more susceptible to cancer infiltration, but the reason remains unknown, and the relationship between the ossification pattern and cancer infiltration has not been studied. The presence of thyroid cartilage ossification, cancer infiltration, ossification pattern (usual: direction from inferior to superior; unusual: other than the usual pattern), and distance between cancer and ossified cartilage were evaluated in laryngectomy specimens. There were 28 and 27 cases of usual and unusual patterns, respectively. There was no association between ossification pattern and cancer infiltration. However, the distance between the ossified area and cancer cells was greater in the usual pattern than in the unusual pattern (p = 0.006). And the usual pattern was more frequently observed in cases with a distance >1 mm than in cases with cancer infiltration or a distance ≤1 mm (p = 0.004). These results suggest the possibility of an active ossification due to tumor progression.

Adult Age Estimation of CT Image Reconstruction of the Laryngeal Cartilages and Hyoid Bone Based on Data Mining.

Objective To explore the feasibility of the CT image reconstruction of laryngeal cartilage and hyoid bone in adult age estimation using data mining methods. Methods The neck thin slice CT scans of 413 individuals aged 18 to <80 years were collected and divided into test set and train set, randomly. According to grading methods such as TURK et al., all samples were graded comprehensively. The process of thyroid cartilage ossification was divided into 6 stages, the process of cricoid cartilage ossification was divided into 5 stages, and the synosteosis between the greater horn of hyoid and hyoid body was divided into 3 stages. Multiple linear regression model, support vector regression model, and Bayesian ridge regression model were developed for adult age estimation by scikit-learn 0.17 machine learning kit （Python language）. Leave-one-out cross-validation and the test set were used to further evaluate performance of the models. Results All indicators were moderately or poorly associated with age. The model with the highest accuracy in male age estimation was the support vector regression model, with a mean absolute error of 8.67 years, much higher than the other two models. The model with the highest accuracy in female adult age estimation was the support vector regression model, with a mean absolute error of 12.69 years, but its accuracy differences with the other two models had no statistical significance. Conclusion Data mining technology can improve the accuracy of adult age estimation, but the accuracy of adult age estimation based on laryngeal cartilage and hyoid bone is still not satisfactory, so it should be combined with other indicators in practice.

Investigating the association between chronological age and thyroid cartilage ossification using CT imaging

Background: Thyroid cartilage ossifies through time. In addition to different methods for age estimation, ossified volume can be a valuable index for age estimation. In this study, anthropometric characteristics and ossified volume were measured using CT scan imaging to find potential correlations between measures and age. Methods: In this study, 100 thyroid cartilage of Iranian corpses (60 men and 40 women) were studied. Corpses from Kahrizak hall of Tehran Legal Medicine Organization were included in this study. After obtaining required consent from their family, their thyroid cartilage was separated by an expert, and anthropometric properties of the cartilage were recorded. A 64-slice Siemens CT scan machine was used to measure specimen ossified volume and Hounsfield score by 3D reconstruction of images. Pearson's correlation test was used to measure the correlation between thyroid calcified volume and chronological age. Repeated measurement ANOVA test was also used to measure the correlation of the ossified volume and Hounsfield score with different age groups. SPSS version 22 was used for statistical analysis, and significance level was set at than 0.05. Results: All thyroid cartilage measures were higher in men than in women, except for thyroid angle, and the differences were statistically significant. Height of the laminae (R=0.23, p=0.023) and depth of the thyroid notch (R=0.198, p=0.049) were correlated with age. Mean ossified volume (6.1±1.7 cc) and Hounsfield score (308.8±53.5 HU) were directly correlated with age (R=0.205; p=0.040 and R=0.219; p=0.029, respectively), but none of these two radiologic parameters were correlated with age groups (p=0.331 and 0.063, respectively). No specific ossification pattern was obtained from CT images in different age groups. Conclusion: A combination of anthropometric measures such as the height of the laminae and depth of the thyroid notch with CT scan imaging measures such as ossified volume and the Hounsfield score are useful to estimate age with low precision. In addition, thyroid cartilage measures are useful for sex determination.

Investigating the association between chronological age and thyroid cartilage ossification using CT imaging

Background: Thyroid cartilage ossifies through time. In addition to different methods for age estimation, ossified volume can be a valuable index for age estimation. In this study, anthropometric characteristics and ossified volume were measured using CT scan imaging to find potential correlations between measures and age. Methods: In this study, 100 thyroid cartilage of Iranian corpses (60 men and 40 women) were studied. Corpses from Kahrizak hall of Tehran Legal Medicine Organization were included in this study. After obtaining required consent from their family, their thyroid cartilage was separated by an expert, and anthropometric properties of the cartilage were recorded. A 64-slice Siemens CT scan machine was used to measure specimen ossified volume and Hounsfield score by 3D reconstruction of images. Pearson’s correlation test was used to measure the correlation between thyroid calcified volume and chronological age. Repeated measurement ANOVA test was also used to measure the correlation of the ossified volume and Hounsfield score with different age groups. SPSS version 22 was used for statistical analysis, and significance level was set at than 0.05. Results: All thyroid cartilage measures were higher in men than in women, except for thyroid angle, and the differences were statistically significant. Height of the laminae (R=0.23, p=0.023) and depth of the thyroid notch (R=0.198, p=0.049) were correlated with age. Mean ossified volume (6.1±1.7 cc) and Hounsfield score (308.8±53.5 HU) were directly correlated with age (R=0.205; p=0.040 and R=0.219; p=0.029, respectively), but none of these two radiologic parameters were correlated with age groups (p=0.331 and 0.063, respectively). No specific ossification pattern was obtained from CT images in different age groups. Conclusion: A combination of anthropometric measures such as the height of the laminae and depth of the thyroid notch with CT scan imaging measures such as ossified volume and the Hounsfield score are useful to estimate age with low precision. In addition, thyroid cartilage measures are useful for sex determination.

Age estimation by ossification of thyroid cartilage of Japanese males using Bayesian analysis of postmortem CT images.

Many studies have reported that the degree of thyroid cartilage ossification correlates with age. However, its use in forensics has been limited by individual variation, tissue fragility, and observer subjectivity. We examined a new method for age estimation from the degree of ossification of thyroid cartilage using postmortem computed tomography (CT) and Bayesian analysis. The scoring of CT density values, ossification rate, and morphological changes was performed in 131 Japanese males (20-80years old), and an age estimation table was created and verified in 39 other Japanese males. We tried two types of prior probability; one was males undergoing postmortem CT imaging at our institute, and the other was the age composition of the male population in Japan. The differences in percentage in each age group were observed, especially in the ninth decade, but they were not large enough to change the result. Two decedents in their 30s and 80s could not be assigned an age group. Likelihood might have had more significant influence than prior probability. Bayesian approach and new scoring system of thyroid cartilage ossification might be useful as an age estimation method. Although the low posterior probability in decedents the age ≧70 remains a problem, the advantage of Bayesian estimation that it can sequentially update the age estimation table by factoring in exceptional data can solve this problem. In this study, accuracy of age estimation did not dramatically increase, however, Bayesian statistics might become a useful technique for examining any tissue samples subject to age-related calcification.

English

English

Thyroid Cartilage Ossification and Multislice Computed Tomography Examination: A Useful Tool for Age Assessment?

Many authors have studied the thyroid cartilage ossification process using radiographic features for age estimation of individuals. Their results were various: Sugiyama reported excellent correlation coefficients between ossification rates and civil age, unlike most other authors. We hypothesized that recent advances in imaging techniques would enable more precise evaluation of the ossification of the thyroid cartilage. We retrospectively analyzed the CT scans of 312 French patients using postprocessing software to examine the pattern of thyroid cartilage ossification, calculating the ossified volume of the cartilage on 3D reconstructions. Pearson's correlation coefficients for volume were 0.73 for men and 0.75 for women (standard error 18.02 and 17.06), indicating considerable inter-individual variability. Although a correlation between civil age and morphological changes was found, these methods based on thyroid cartilage ossification were not accurate enough for the assessment of individual age.

Examination of pattern of RI accumulation in thyroid cartilage on bone scintigraphy

In bone scintigraphy, abnormal RI accumulation in ossified thyroid cartilage is often noted. However, because similar accumulation is also seen in tumor-involved cartilage, distinction between these two lesions is sometimes difficult. We examined the differences in RI accumulation by ossification of the thyroid cartilage and cartilage invasion with anterior, posterior, and oblique views of bone scintigraphy in this study. This study included 120 patients (104 men, 16 women; mean age 67.8 +/- 9.6 years; range 48-90 years) with laryngeal or lower pharyngeal carcinoma. The patients had exhibited abnormal accumulation of RI on thyroid cartilage on bone scintigraphy between February 1999 and March 2007. We evaluated accumulation of thyroid cartilage in the anterior, posterior, and oblique views on bone scintigraphy. The presence/absence of tumor invasion of the thyroid cartilage was checked by comparing the findings of enhanced computed tomography and magnetic resonance imaging (MRI) as well as evaluating operative records. RI accumulation in thyroid cartilage was divided into four types (diffuse accumulation, intense diffuse accumulation, slight inhomogeneous accumulation, and intense inhomogeneous accumulation). Tumor invasion of thyroid cartilage was noted in 2 of the 42 patients with diffuse accumulation, 1 of the 18 patients with intense diffuse accumulation, 1 of the 38 patients with slight inhomogeneous accumulation, and 17 of 22 patients with intense inhomogeneous accumulation. Because the degree of tumor invasion was highest in cases in which bone scintigraphy revealed intense inhomogeneous accumulation of RI in the thyroid cartilage, we judged this pattern of RI accumulation to be an indicator of tumor invasion. When diagnosis was based on this criterion, positive predictive value, negative predictive value, and accuracy were 77%, 96%, and 93%, respectively (P < 0.0001, Chi-square test). The findings of this study suggest that ossification of thyroid cartilage can be distinguished from tumor-involved thyroid cartilage on the basis of the pattern of abnormal RI accumulation in the thyroid cartilage in patients with head/neck cancer.

Der Einfluss der Schildknorpelossifikation bei der Larynxsonografie

Topological features of the larynx and hypopharynx may be depicted during sonographic examination of the neck, although ultrasound is seen of minor diagnostic importance. The varying extend of thyroid cartilage ossification appears to be the major limiting factor. We intended to assess the sonographic accessability of laryngeal structures with high end resolution ultrasound devices. We examined 101 patients endoscopically and by ultrasound. Normal laryngeal findings and pathologies were examined and analysed considering limitations by thyroid cartilage ossification. Despite varying grades of ossification, the majority of laryngeal structures were clearly displayed by ultrasound. Ossification was increasing in the elderly. In 16 cases (16 %) ossification prevented a successful evaluation. In 9 cases of malignant tumor and one laryngocele sonographic assessment was able to contribute additional diagnostic information. Ultrasound of the larynx requires methodical experience of the operator but is capable to depict relevant anatomic structures, even with presence of thyroid cartilage ossification, thus being able to increase diagnostic impact and may save additional imaging modalities.

Onco-surgical significance of anatomomorhological specificity of glottic region of the larynx

Glottis is a medium level of the larynx, involving the vocal cords, vocal process of arytenoid cartilage, and the anterior and posterior commissures. This region of heterogeneous histomorphological structure has specific characteristics: the internal striated muscles, the outer and inner perichondrium, atypical intra-cartilaginous areas of ossification, and unusual muscular insertion to cartilage. Microtomy of 3 thick successive sections was performed at the level of the upper surface of vocal cords. Standard histological staining methods were used. Microphotographs were taken by light microscope under different magnification along with histomorphometric measurements. Cancer spread is partially restricted by anatomic barriers: vocal ligament and tendon of the anterior commissure, and subsequently by the elastic cone. Easier tumor extension may be due to absence of the internal perichondrium and ossification of thyroid cartilage. Microvascularization of the anterior commissure is significant for tumor spread in glottis and paraglottic space. The role of commissural lymph network in local spread of the cancer is completely vague. It is certain that there are causes, still unrecognized, which have an effect on the pathways and direction of malignant tumor spread.

Temporal and spatial localization of type I and II collagens in human thyroid cartilage.

Thyroid cartilages of various ages were investigated by immunofluorescence staining for localization of the fibrillar collagen types I and II in order to understand the tissue remodeling occurring during the mineralization and ossification of thyroid cartilage. In fetal and juvenile thyroid cartilages, type I collagen was restricted to the inner and outer perichondrium, while type II collagen was localized in the matrix of hyaline cartilage. However, in advanced ages, type I collagen was also localized in the pericellular and in the interterritorial matrix of intermediate and central chondrocytes of thyroid cartilage. The matrix of peripheral chondrocytes was negative for type I collagen. This suggest that some chondrocytes in thyroid cartilage undergo a differentiation to type I collagen-producing chondrocytes. At the beginning of ossification, bone-related type I collagen was chiefly detected in the central cartilage layer, but was never deposited first from the perichondrium in the direction to the subperichondrial cartilage. This observation confirmed previous findings showing that osteogenesis mainly follows an endochondral ossification pattern. Interterritorial matrix failed to react with the type II collagen antibody in men from the beginning of the third decade, and later still in women, even after treatment with hyaluronidase. These observations indicate that major matrix changes occur faster in male than in female thyroid cartilage.

Transmission of ultrasound through the larynx as a means of determining vocal-fold activity.

A procedure is reported for determining vocal-fold closure using a technique of transmitting continuous-wave ultrasound through the larynx. A frequency of 3.2 MHz and an applied acoustic power of less than 1 mV/cm 2 was used. Physiological interpretation of received signals is discussed in terms of glottal closure, vocal-fold thickness, vocal-fold vibratory pattern, and thyroid cartilage ossification. Suggestions are offered for choice and arrangement of transducers for this application.