甲状軟骨形成術が有用であった甲状軟骨形成異常の１例

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  • A Case of Congenital Malformation of the Thyroid Cartilage.

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Congenital laryngeal malformation is very rare, in particular for the laryngeal cartilage. We report the case of an anomaly of the thyroid cartilage of a patient who complained of voice disorder without respiratory or feeding problems. The subject was a 50-year-old male, who had complained of a singular voice disorder which appeared as breathy hoarseness, falsetto, and vocal fry alternately at random. Fiberscopic findings revealed that the left vocal fold was narrow and higher than the right, and that the glottal closure was incompetent without disorders of bilateral vocal fold movements. On inspection, his thyroid prominence was bifid, and the left thyroid lamina was depressed. A horizontal CT scan and coronal tomography of the larynx also revealed similar findings for the thyroid cartilage, and the other laryngeal cartilages were intact. Manual tests (compression of the thyroid lamina, and approximation of the crico-thyroidal space) for thyroplasty were positive on the left side. We performed thyroplasty types I and IV, under local anesthesia. On intraoperative findings, we confirmed that the left thyroid lamina was depressed with abnormal growth of veins, the thyroid prominence was bifid, and the cricothyrodal space was enlarged. After the operation, his voice improved.

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