Subject-Specific Modeling of Implant Placement for Type I Thyroplasty Surgery
Name
10439_2023_3250_ReferencePDF.pdf
Size
853.4 KB
Format
Adobe PDF
Checksum (MD5)
1689c796df3a642f46478b8a7add1fef
Author(s)
Li, Zheng
Wilson, Azure
Sayce, Lea
Ding, Alice
Rousseau, Bernard
Luo, Haoxiang
Date Issued
June 1, 2023
Publisher
Springer International Publishing
Citation
Li, Zheng, Wilson, Azure, Sayce, Lea, Ding, Alice, Rousseau, Bernard et al. 2023. "Subject-Specific Modeling of Implant Placement for Type I Thyroplasty Surgery."
Version
Author's final manuscript
Abstract
Abstract
Type I thyroplasty is widely used to improve voice production in patients affected by unilateral vocal fold paralysis. Almost two-thirds of laryngologists report using Silastic® implants to medialize the vocal fold, with implant size, shape, and location determined experientially. However, post-surgical complications arising from this procedure (extrusion, migration, resizing) necessitate revision in 4.5–16% of patients. To improve initial surgical outcomes, we have developed a subject-specific modeling tool, PhonoSim, which uses model reconstruction from MRI scans to predict the optimal implantation location. Eleven vocal fold sample sides from eight larynges of New Zealand white rabbits were randomized to two groups: PhonoSim informed (n = 6), and control (no model guidance, n = 5). Larynges were scanned ex vivo in the abducted configuration using a vertical-bore 11.7 T microimaging system, and images were used for subject-specific modeling. The PhonoSim tool simulated vocal fold adduction for multiple implant location placements to evaluate vocal fold adduction at the medial surface. The best implant placement coordinates were output for the 6 samples in the PhonoSim group. Control placements were determined by the same surgeon based on anatomical landmarks. Post-surgical MRI scans were performed for all samples to evaluate medialization in implanted vocal folds. Results show that PhonoSim-guided implantation achieved higher vocal fold medialization relative to controls (28 to 55% vs. − 29 to 39% respectively, in the glottal area reduction), suggesting that this tool has the potential to improve outcomes and revision rates for type I thyroplasty.
MIT Department
Massachusetts Institute of Technology. Department of Nuclear Science and Engineering
Terms of Use
Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1007/s10439-023-03250-w
