基于颈部CT影像学的儿童及青少年喉部发育研究

Development of the larynx in children and adolescents according to the findings of computed tomography of the neck

目的基于颈部CT平扫图像探讨儿童和青少年喉部的发育规律。方法选取2008年1月至2017年12月盛京医院行颈部CT检查的儿童和青少年为研究对象。共纳入910例患者,男514例,女396例。本研究经中国医科大学附属盛京医院伦理审查委员会批准(2018PS469K),对所有患者颈部CT进行多平面重建和测量,测量声门下和环状软骨的横径和前后径,并计算声门下/环状软骨横径比值和声门下/环状软骨前后径比值。结果患者声门下横径和前后径分别为(9.0±2.6)mm、(11.1±4.3)mm,环状软骨横径和前后径分别为(11.6±3.2)mm、(11.8±3.4)mm,声门下/环状软骨横径和声门下/环状软骨前后径比值分别为0.78±0.08和1.19±0.09。喉部气道内径与年龄呈正相关(P<0.001),但声门/环状软骨横径和声门/环状软骨前后径比值与年龄不相关。结论儿童和青少年声门下横径是喉部最狭窄的内径。随着年龄增加,喉部气道内径增大,但喉部的形态未发生明显变化。

Objective To explore the development of the larynx in children and adolescents using neck computed tomography(CT)Methods Children and adolescents who underwent neck CT scans at Shengjing Hospital from January 2008 to December 2017 were included in this study.Nine hundred and ten patients were enrolled,including 514 males and 396 females.This study was approved by the Ethical Review Committee of Shengjing Hospital of China Medical University(2018PS469K).Multiplanar reconstruction and analysis of the anatomical features observed on neck CT were performed in all the patients.The transverse and anteroposterior diameters of the subglottic and cricoid cartilages were measured,and the subglottic/cricoid transverse diameter ratio and subglottic/cricoid anteroposterior diameter ratio were calculated.Results Deviation of transverse and anteroposterior diameters of the subglottis was 9.0±2.6 mm and 11.1±4.3 mm,respectively;while that of the transverse and anteroposterior diameters of the cricoid cartilage was 11.6±3.2 mm and 11.8±3.4 mm,respectively.The average ratios of the transverse and anteroposterior diameters of the subglottis/cricoid cartilage were 0.78±0.08 and 1.19±0.09,respectively.The diameters of the larynx were positively correlated with age(P<0.001),but the ratios of the transverse and anteroposterior diameters of the subglottis/cricoid cartilage were not related with age.Conclusion The transverse diameter of the subglottis is the narrowest diameter of the larynx.The diameters of the larynx increase with age,but the shape of the larynx does not change during development.