急診頸椎電腦斷層中聲帶萎縮的盛行率

背景及目的：聲帶萎縮普遍認為與老化有關，在老年人應該較多，目前有關之研究均著眼於耳鼻喉科門診患者。本文特以回顧性影像學的方法，試圖在曾接受過急診頸椎電腦斷層的患者群中找出一般族群的狀況。方法：共計233名患者（男127，女106）納入本研究，年齡46.0 ± 19.2（平均值±標準差）歲，曾於2010年9月至2011年4月間接受急診頸椎電腦斷層。運用表面數位重建以虛擬喉鏡辨認是否具聲帶萎縮，接著利用2維多層面數位重建找到恰位於兩側杓骨尖端與前聯合後端的聲門平面，測量前聯合厚度、兩側膜性聲帶平均直線長度及夾角，以及聲門氣道面積。統計分析採用卡方檢定與雙尾t檢定，α值設為.01。結果：共14.2%（n = 33）具有聲帶萎縮，其中僅12.1% （4 of 33）為老年人（≧65歲）。不論男性或女性，有無聲帶萎縮者在老年或非老年人間並無差異（p = .8232 & .1337）。聲帶萎縮對女性的影響較男性明顯；在前者，前聯合厚度較小（p = 7.66 × 10^-6），兩側膜性聲帶平均直線長度較長（p = .0002），聲門氣道面積較大（p = .0006）；在後者，僅兩側膜性聲帶平均直線長度較長（p = .0097）結論：聲帶萎縮並非在老年人較多，或許僅是一種解剖學上的異常，不全然是老化所致。

關鍵字

聲帶萎縮；虛擬喉鏡；表面數位重建； 2維多層面數位重建；頸椎電腦斷層

並列摘要

Background and Purpose: Vocal fold atrophy (VFA) is thought to be associated with aging and prevalent in the aged population. However, current studies have been limited to otolaryngological outpatients alone. We performed a retrospective imaging study to investigate the general prevalence of VFA in patients undergoing emergent cervical spinal computed tomography.Methods: In total, 233 patients, including 127 males and 106 females (age, 46.0 ± 19.2 years), who underwent emergent cervical spinal computed tomography between September 2010 and April 2011, were enrolled. Virtual laryngoscopy with surface rendering was performed to differentiate VFA from other conditions, and 2D multiplanar reformatting was performed to generate the axial cut at the vocal points of the bilateral arytenoid cartilages and the posterior end of the anterior commissure. The anterior commissure thickness, the straight length and included angle of the bilateral membranous vocal folds, and the glottic airway area were measured. A chi-square test and a two-tailed t test (α = 0.01) were used for statistical analysis of the data.Results: A total of 14.2% (n = 33) patients had VFA; of these, 12.1% (4/33) were aged ≥ 65 years. No statistical difference was observed in VFA between the aged and nonaged in the male or female patients (p = 0.8232 and 0.1337, respectively). However, the influence of VFA was more prominent in the females than the males; the females with VFA revealed thinner anterior commissures (p = 7.66 × 10^(-6)), longer straight lengths of bilateral membranous vocal folds (p = 0.0002), and larger glottic airways (p = 0.0006) compared with those in females without VFA; on the other hand, males with VFA revealed longer straight lengths of bilateral membranous vocal folds (p = 0.0097) compared with those in males without VFA.Conclusions: VFA was not more prevalent in the aged than in the common adult population, but it may be an anatomical variation that is not caused by aging.

並列關鍵字

vocal fold atrophy ； virtual laryngoscopy ； surface rendering ； 2D multiplanar reformatting ； cervical spinal computed tomography

國際替代計量

急診頸椎電腦斷層中聲帶萎縮的盛行率

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