3-DIMENSIONAL MOTION OF THE ARYTENOID ADDUCTION PROCEDURE IN CADAVER LARYNGES

To determine whether variation in suture placement could improve the r esults of the arytenoid adduction procedure, a model was developed usi ng fresh human cadaver larynges. Three-dimensional (3-D) motion of the arytenoid was determined by utilizing computed tomographic imaging wi th radiopaque markers on the apex and muscular and vocal processes. By utilizing principles previously applied to the study of rigid body me chanics for the carpal, knee, and tarsal joints, rotation and translat ion of the arytenoid about the axial, coronal, and sagittal axes were calculated. Subglottic airflow resistance was measured before and afte r the procedure. Posterior glottic closure was reproducibly achieved, as determined by computed tomographic imaging and airway resistance. C onflicting reports on cricoarytenoid joint mechanics can be attributed to reliance on trigonometric analysis of two-dimensional images, whic h results in errors in out-of-plane motion. This paper presents a usef ul model for obtaining detailed anatomic information describing aryten oid 3-D motion.