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Research ArticleHEAD & NECK

Evaluating “Eee” Phonation in Multidetector CT of the Neck

V.V. Wear, J.W. Allred, D. Mi and M.K. Strother
American Journal of Neuroradiology June 2009, 30 (6) 1102-1106; DOI: https://doi.org/10.3174/ajnr.A1529
V.V. Wear
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J.W. Allred
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D. Mi
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M.K. Strother
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Article Figures & Data

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  • Fig 1.
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    Fig 1.

    A, Motion scores above the glottis by using “eee” phonation and breath-hold techniques. More than 80% of both groups had no or only mild motion. B, Motion scores at the glottis by using “eee” phonation and breath-hold techniques. Despite the mild vibratory motion necessary for phonation, scores did not differ significantly between phonation and breath-hold, and most patients did not have any significant motion. C, Motion scores below the glottis by using “eee” phonation and breath-hold techniques. Because scanning commenced from cranial to caudal, there was concern that patients would move as they ran out of breath. However, motion scores are best below the glottis. mod indicates moderately.

  • Fig 2.
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    Fig 2.

    Axial CT images through the neck at the glottis demonstrate the range of motion seen in this study. All images are from separate patients who performed “eee” phonation. A−C, No motion (A), mild motion (B), and severe motion (C).

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    Fig 3.

    The odds ratio comparing phonation to the breath-hold technique is given above the glottis, at the glottis, and below the glottis. The estimated odds ratio is the center line, shouldered by an 80% confidence interval (darkest gray bar) and a 95% confidence interval (gray bar).

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    Fig 4.

    A 48-year-old man with squamous cell carcinoma of the supraglottic larynx. CT was acquired during “eee” phonation. A coronal reformatted image is shown. Because the pyriform sinuses (asterisks) are distended with air, the margins of the tumor are clearly delineated (arrowheads). Because tumor involved the undersurface of the high left pyriform sinus wall, a pharyngotomy was required. The thin arrow marks the laryngeal ventricle, which is distended with air during “eee” phonation.

Tables

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  • Patient scores for “eee” phonation and breath-hold maneuvers*

    Control (n = 96)“Eee” Phonation (n = 48)P Values
    Age (years)55.69 ± 14.4455.69 ± 14.521.000†
    Sex1.000‡
        Male69% (66)69% (33)
        Female31% (30)31% (13)
    Reader 1
        Above larynx.704§
            156% (54)62% (30)
            228% (27)19% (9)
            39% (9)6% (3)
            43% (3)10% (5)
            53% (3)2% (1)
        At larynx
            153% (51)50% (24).845§
            229% (28)33% (16)
            310% (10)12% (6)
            45% (5)0% (0)
            52% (2)4% (2)
        Below larynx
            156% (54)69% (33).117§
            230% (29)25% (12)
            312% (12)4% (2)
            41% (1)2% (1)
    Reader 2
        Above larynx.194§
            132% (31)48% (23)
            252% (50)35% (17)
            310% (10)8% (4)
            45% (5)6% (3)
            50% (0)2% (1)
        At larynx.972§
            120% (19)19% (9)
            262% (60)65% (31)
            315% (14)12% (6)
            43% (3)2% (1)
            50% (0)2% (1)
        Below larynx.195§
            171% (68)60% (29)
            223% (22)29% (14)
            36% (6)10% (5)
            40% (0)0% (0)
    • * Scoring is as follows: 1 indicates no motion; 2, mild motion; 3, moderate motion; 4, moderately severe motion; 5, severe motion. Numbers after percentages are frequencies.

    • † Wilcoxon test.

    • ‡ Pearson test.

    • § Proportional odds likelihood ratio test.

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American Journal of Neuroradiology: 30 (6)
American Journal of Neuroradiology
Vol. 30, Issue 6
June 2009
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Evaluating “Eee” Phonation in Multidetector CT of the Neck
V.V. Wear, J.W. Allred, D. Mi, M.K. Strother
American Journal of Neuroradiology Jun 2009, 30 (6) 1102-1106; DOI: 10.3174/ajnr.A1529

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Evaluating “Eee” Phonation in Multidetector CT of the Neck
V.V. Wear, J.W. Allred, D. Mi, M.K. Strother
American Journal of Neuroradiology Jun 2009, 30 (6) 1102-1106; DOI: 10.3174/ajnr.A1529
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