喉閃頻內視鏡為現今臨床上最常使用的咽喉檢查儀器，但由於每次影像拍攝位置不同，病患聲帶尺寸也不相同，而每位醫師依照自身經驗的觀點容易有主觀認定差異，無法直接估計喉部參數尺寸及客觀進行診療資訊的交流與判斷。本研究研發具有可靠客觀量測之雷射投影裝置附加於喉閃頻內視鏡上，藉由3D列印之快速開發及輕量化特性進行內部管路及光學設計，搭配可重複使用之輕金屬材料製作外殼，總重量為122公克。此裝置提供影像尺度轉換參考參數，其平均準確度達99.13%；並開發專屬之影像辨識輔助系統，可分割喉部重要區域並提取生理參數，自動取得最大聲門面積、左邊聲帶長度、左邊聲帶寬度、左邊聲帶面積、右邊聲帶長度、右邊聲帶寬度、右邊聲帶面積、張開聲帶總面積、聲門角度、總聲帶寬度、閉合聲帶面積、閉合聲帶長度以及閉合聲帶寬度等生理參數並量化。
　　本研究共收集了84位正常受試者及36位全身麻醉氣管插管之手術病人，利用所研製之雷射投影裝置取得生理參數等實驗數據，對BMI、年齡等因子進行線性迴歸分析(Regression Analysis)，證明年齡越大者有聲門面積逐漸變小的趨勢(p=0.027)，而在氣管插管全身麻醉手術病人方面，術後聲門面積與聲門角度明顯小於術前25%，左邊聲帶面積、右邊聲帶面積與張開聲帶總面積分別高於術前31%、32%及32%。本研究使用數種資料分析方法將各項喉部生理參數進行分類，並依此提出全身麻醉氣管插管手術病人喉部是否發炎之診斷評估指標，再由接收者操作特徵曲線(ROC)及約登指數（Youden Index）求出最佳閾值，以評估是否需進一步治療之必要性。在喉部生理參數部分，透過多元迴歸模型得到最佳模型準確率為86.5%，ROC下面積(AUC)為0.8294，意味著該閾值具有極佳的判別能力(AUC > 0.8)，而在色相紋理方面，可依勺狀間隙的色相及紋理變化有效分類出發炎與否，本研究所提出的發炎判斷指標其準確率為94.4%，ROC下面積(AUC)為0.912。
　　本研究以喉部生理參數與勺狀間隙之色相及紋理提出判斷喉部是否發炎之依據，並證實了因氣管插管會造成聲帶紅腫、喉部發炎等現象，此結果可做為後續研究及臨床上手術前後復原狀況的參考依據，輔助醫師參考評估並給予適當治療，進而提升醫療品質。

　　The laryngostroboscopic endoscopy is currently the most commonly used throat examination instrument in clinical practice. However, due to the different image shooting positions required each time and the various sizes of the patient's vocal cords, each physician's point of view is likely to be subjectively determined, as based on experience, and it is impossible to directly and reliably know the sizes and parameters of the larynx and make objective determination and communication regarding the diagnosis and treatment information. In this study, a laser projection device for reliable and objective measurement was attached to the laryngostroboscopic endoscope, which has the 3D printing features of quick development and lightweight for internal piping and optical design. The housing was made of reusable light metal material, with a total weight of only 122 g. The device developed by this study can provide reference parameters for image scale conversion with 99% accuracy. An exclusive image recognition aid system was also developed to segment the important areas of the larynx, and extract its physiological parameters. Moreover, it could automatically obtain quantitative parameters, such as glottal area, closed vocal cord area, closed vocal cord length, and closed vocal cord width.
　　This study collected a total of 84 normal subjects and 36 patients undergoing tracheal intubation under general anesthesia. The developed laser projection device was used to obtain the experimental data of physiological parameters, and linear regression analysis was performed on various factors, such as BMI and age. The results prove that the older the age, the smaller the glottal area gradually becomes (p=0.027). and for patients undergoing general anesthesia for tracheal intubation, the postoperative glottal area and glottal angle are significantly less than 25% before surgery, and the left vocal cord area .The area of the right vocal cords and the total area of the open vocal cords were 31%, 32%, and 32% higher than those before surgery. In this study, several data analysis methods were used to classify various physiological parameters of the larynx, and based on this, the diagnostic evaluation index of whether the larynx of patients undergoing tracheal intubation surgery under general anesthesia was put forward, and then the receiver's operating characteristic curve (ROC) and approximate Youden Index finds the optimal threshold to assess the need for further treatment. In the part of physiological parameters of the larynx, the best model accuracy rate obtained through the multiple regression model is 86.5%, and the area under ROC (AUC) is 0.8294, which means that the threshold has excellent discrimination ability (AUC> 0.8). On the other hand, it can be effectively classified according to the hue and texture of the spoon-shaped gap. The accuracy of the inflammation judgment index proposed in this study is 94.4%, and the area under the ROC (AUC) is 0.912.
　　This study used the physiological parameters of the larynx and the hue and texture of the spoon-shaped gap to provide a basis for judging whether the larynx is inflamed, and confirmed that the tracheal intubation can cause swelling of the vocal cords and inflammation of the larynx. This result can be used as a follow-up study and Clinically, the reference basis for the recovery status before and after surgery, assisting physicians to refer to and evaluate and give appropriate treatment, thereby improving the quality of medical treatment.

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