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Yogev D, Madgar O, Goldberg T, Parmet Y, Guranda L, Havazelet S, Vazgovsky O, Tejman-Yarden S, Primov-Fever A. Virtual Reality-Enhanced Assessment of the Anterior Glottic Angle Using Cadaveric Models: A Proof-of-Concept Study. J Voice 2024:S0892-1997(24)00183-8. [PMID: 39033032 DOI: 10.1016/j.jvoice.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVES Vocal fold paralysis (VFP) is a complex disorder that affects voice, speech, swallowing, and overall quality of life. Current evaluation methods for determining the position of paralyzed vocal folds lack the objectivity required for personalized interventions and research on innovative treatments for VFP. This study was designed to validate the accuracy and reproducibility of a virtual reality (VR)-based platform to measure the anterior glottic angle (AGA), a critical component in determining the position of a paralyzed vocal fold. STUDY DESIGN Retrospective. METHODS A retrospective analysis of computed tomography (CT) scans of 39 adult patients was conducted to measure the AGA shortly after death. Two measurement methods were used: 2-dimensional (2D)-CT for direct measurements on 2D images and a 3-dimensional (3D)-VR method utilizing a dedicated platform to create a 3D VR model of the larynx. The AGA measurements conducted by two senior otolaryngologists using the 3D-VR method were compared to the 2D-CT measurements made by one of these same otolaryngologists. RESULTS The mean AGA measured by the 3D-VR method was found to be 32.936 ± 6.486° (n = 39), and the measurements were highly correlated (r = 0.9670, P < 0.0001). By contrast, the 2D-CT method without VR yielded a significantly lower mean angle of 23.754° (n = 35) with a higher standard deviation of 10.365°. The 3D-VR method demonstrated excellent reliability for AGA measurements (intraclass correlation coefficient of 0.954). CONCLUSION The findings underscore the potential value of using a VR-based platform to improve reproducibility and reduce the variability in measurements of AGA in cases of VFP.
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Affiliation(s)
- David Yogev
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Engineering Medical Research Lab, Sheba Medical Center, Ramat-Gan, Israel.
| | - Ory Madgar
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Tomer Goldberg
- Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Engineering Medical Research Lab, Sheba Medical Center, Ramat-Gan, Israel
| | - Yisrael Parmet
- Department of Industrial Engineering and Management, Ben Gurion University, Beer Sheva, Israel
| | - Larisa Guranda
- Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; Division of Diagnostic Imaging, Sheba Medical Center, Ramat-Gan, Israel
| | - Shany Havazelet
- Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
| | - Oliana Vazgovsky
- Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Engineering Medical Research Lab, Sheba Medical Center, Ramat-Gan, Israel
| | - Shai Tejman-Yarden
- Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Engineering Medical Research Lab, Sheba Medical Center, Ramat-Gan, Israel
| | - Adi Primov-Fever
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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Shivatzki S, Yogev D, Goldberg T, Parmet Y, Dagan M, Vazgovsky O, Tessler I, Sagiv D, Tejman-Yarden S, Primov-Fever A. Virtual Reality Helps Describe the Progression of Thyroid Cartilage Calcification. J Voice 2024:S0892-1997(24)00030-4. [PMID: 38523021 DOI: 10.1016/j.jvoice.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVES Thyroid cartilage (TC) calcifications may impact surgical planning and clinical management. However, few studies to date have implemented virtual reality (VR) to evaluate these calcifications. This study assessed the feasibility of evaluating TC calcifications in various regions and measuring their volumes through VR models generated from computed tomography scans. We also investigated age and gender-related differences in calcification patterns. METHODS Ninety-two participants were categorized into younger, middle-aged, and older age groups. Calcification patterns (degree in Hounsfield units and volume of calcification in cm3) in different TC regions were identified by VR analysis, which enabled comparisons between age groups and genders. RESULTS Significant differences in calcification patterns were observed between males and females, particularly in the middle right, middle left, bottom left, and vertex regions. Age-related differences in the vertex region showed increased calcification in the older age group. CONCLUSION This study points to the contribution of VR in the evaluation of complex anatomical structures. The findings revealed significant gender and age patterns in TC calcification. These insights can inform surgical planning and highlight the potential of using VR to gain a better understanding of TC calcification clinically.
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Affiliation(s)
- Shaked Shivatzki
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel; The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel; The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - David Yogev
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel; The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel; The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tomer Goldberg
- The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel; The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yisrael Parmet
- Department of Industrial Engineering and Management, Ben Gurion University, Beer Sheva, Israel
| | - Mayan Dagan
- The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel
| | - Oliana Vazgovsky
- The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel
| | - Idit Tessler
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel; The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Doron Sagiv
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, California
| | - Shai Tejman-Yarden
- The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel; The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adi Primov-Fever
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel; The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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