DYNAMIC MAGNETIC-RESONANCE-IMAGING OF VOCAL CORD CLOSURE DURING DEGLUTITION

Background & Aims: Vocal cord closure is instrumental in airway protection during deglutition. Conventional imaging of vocal cord closure and reopening during deglutition requires invasive and nonphysiological methods. The aim of this study was to characterize the biomechanical properties of normal vocal cord adduction/abduction during deglutition using echoplanar magnetic resonance imaging, a technique that has the capability of imaging soft-tissue motion with real-time temporal resolution. Methods: The movements of laryngeal and vocal cord structures during swallowing were determined in 11 normal volunteers by single slice and axially reformatted multislice coronal echoplanar images. Results: During swallowing, the larynx ascended to peak elevation, maintained peak elevation for a discrete interval, and descended to its resting position. Vocal cord adduction occurred with a symmetric tent-like configuration at the midpoint of maximal laryngeal elevation, whereas vocal cord abduction occurred at the midpoint of laryngeal descent. Spatial analysis of vocal cord configuration during adduction determined that the Vocal cords attained an initial parallel configuration during ascent, followed by closure at peak laryngeal elevation. Conclusions: These results show that the vocal cords adduct and abduct synchronously with laryngeal ascent and descent, respectively, during deglutition. Echoplanar magnetic resonance imaging constitutes a novel tool used to assess clinical abnormalities of deglutitive laryngeal function.