CT Scans Improve Pediatric Voice Surgery Precision
Research By: Anisha Noble, MD, MS | Alessandro de Alarcon, MD, MPH
Post Date: August 12, 2024 | Publish Date: Aug. 12, 2024
Otolaryngology | Top Scientific Achievement
A multidisciplinary team at Cincinnati Children’s reports success from using a non-invasive imaging technique to tailor surgery for children with dysphonia caused by posterior glottic diastasis (PGD).
With this condition, the back portion of the vocal folds does not close properly, resulting in a weak, breathy voice. Using dynamic voice computed tomography (DVCT), researchers were able to visualize and measure the amount of cricoid cartilage that should be removed during endoscopic posterior cricoid reduction (ePCR)—a minimally invasive surgery designed to close the gap and improve vocal quality.
Results were published in December 2024 in The Laryngoscope.
Led by Anisha Noble, MD, MS, the study compared 17 dysphonic patients who underwent ePCR with 19 non-dysphonic children. Results revealed that healthy children could tolerate a posterior glottic gap of about 1.3 millimeters, while children with PGD averaged 2.4 millimeters. After surgery, patients’ voice handicap scores and perceptual voice ratings improved significantly, confirming the safety and efficacy of reducing the cricoid by approximately 1.6 millimeters.
“Dynamic voice CT gives us a precise, noninvasive way to tailor surgery for each child,” Noble says. “It helps us protect airway function while meaningfully improving their voice.”
The findings provide critical benchmarks for clinicians worldwide, establishing the first pediatric reference range for normal and pathologic posterior glottic gaps. The research also reinforces Cincinnati Children’s leadership in developing imaging-guided approaches that improve outcomes for children with complex airway disorders.
Next, the team plans to refine DVCT protocols and study age- and gender-specific norms to further enhance surgical precision.
About the study
Cincinnati Children’s co-authors included Robert Fleck, MD; Matthew Maksimoski, MD; Kevin McElfresh, MA, CCC-SLP; Meredith Tabangin, MPH; and Alessandro de Alarcón, MD, MPH.
This research was supported by the National Institutes of Health (R01 DC018008).
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| Original title: | Evaluation of Pediatric Posterior Glottic Diastasis Using Dynamic Voice Computed Tomography |
| Published in: | The Laryngoscope |
| Publish date: | Aug. 12, 2024 |
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