ECHO-PLANAR MAGNETIC-RESONANCE-IMAGING OF DEGLUTITIVE VOCAL FOLD CLOSURE - NORMAL AND PATHOLOGICAL PATTERNS OF DISPLACEMENT

Abnormalities of vocal fold closure during deglutition predispose to a spiration due to impairment of airway protection. Conventional assessm ent of deglutitive vocal fold motion with laryngoscopy does not permit visualization through a complete adduction-abduction cycle. We determ ined spatiotemporal patterns of deglutitive vocal fold adduction throu gh echo-planer magnetic resonance imagining in 15 normal volunteers an d 6 patients with vocal paralysis. In normal volunteers, deglutitive v ocal fold adduction was synchronized with laryngeal elevation, with co mplete vocal fold closure at the apex. Patients with unilateral vocal paralysis demonstrated reduced elevation and medial movement of the in volved vocal fold. At maximal laryngeal elevation the uninvolved vocal fold attained a position superior to the paralyzed fold, resulting in level differences and an interglottic gap. Patients with bilateral vo cal fold paralysis demonstrated reduced elevation and medial movement of both vocal folds. These findings indicated that normal and abnormal patterns of vocal fold displacement can be distinguished noninvasivel y through the use of echo-planar imaging.