A new thread guide instrument for endoscopic arytenoid lateropexy.
Summary of "A new thread guide instrument for endoscopic arytenoid lateropexy."
OBJECTIVES/
HYPOTHESIS:
: The varied etiology of bilateral vocal cord immobility (BVCI) requires a wide range of surgical approaches. A new endolaryngeal thread guide instrument (ETGI) is presented here for a minimally invasive endoscopic lateropexy of the arytenoid cartilage, which might serve as a basis for a simple solution for the main types of BVCI. STUDY
DESIGN:
: Prospective study of BVCI patients who underwent surgery, including 22 bilateral vocal cord paralyses (BVCP), 12 mechanical fixations (MF), 10 posterior glottic stenoses, and two rheumatoid ankyloses.
METHODS:
: The ETGI is based on a built-in movable curved blade with a hole at its tip to guide a thread in and out again between the skin and the laryngeal cavity. The loops formed around the arytenoid cartilage cause abduction. In cases of fixations, the cricoarytenoid joints were properly mobilized as a first step with a combination of cold technique and CO(2) laser.
RESULTS:
: As spirometric tests proved, 32 patients achieved improved breathing ability. One temporary tracheostomy was necessary and one patient with ongoing radiotherapy could not be decannulated. Subjectively, twelve patients' voices improved or approximated normal quality due to complete vocal cord recoveries on at least one side after lateropexy was ceased. Incomplete recovery with more or less impaired voice was observed in 16 cases. Three MF patients and two BVCP patients with poor overall health condition had severe dysphonia.
CONCLUSIONS:
: Combined with simple and readily available methods, endoscopic arytenoid lateropexy is an effective solution for BVCIs with various etiologies. The ETGI facilitates this procedure with rapid and safe creation of fixating loops at the proper position. Laryngoscope, 2010.
Affiliation
Department of Otorhinolaryngology and Head and Neck Surgery , Faculty of Medicine, University of Szeged, Szeged, Hungary.
Journal Details
This article was published in the following journal.
Name: The Laryngoscope
ISSN: 1531-4995
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20824739
- DOI: http://dx.doi.org/10.1002/lary.21055
Medical and Biotech [MESH] Definitions
Cholangiopancreatography, Endoscopic Retrograde
Fiberoptic endoscopy designed for duodenal observation and cannulation of VATER'S AMPULLA, in order to visualize the pancreatic and biliary duct system by retrograde injection of contrast media. Endoscopic (Vater) papillotomy (SPHINCTEROTOMY, ENDOSCOPIC) may be performed during this procedure.
Sphincterotomy, Endoscopic
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Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES).
Hemostasis, Endoscopic
Control of bleeding performed through the channel of the endoscope. Techniques include use of lasers, heater probes, bipolar electrocoagulation, and local injection. Endoscopic hemostasis is commonly used to treat bleeding esophageal and gastrointestinal varices and ulcers.
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