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Partial laser arytenoidectomy in the management of bilateral vocal fold immobility. A modification based on functional anatomical study of the cricoarytenoid joint.
Saudi Med J. 2005 Oct; 26(10):1539-45.SM

Abstract

OBJECTIVES

To establish the anatomical relationships of the arytenoid and cricoid cartilages and apply these findings to design an arytenoidectomy based on a sound anatomical basis.

METHODS

We prospectively conducted this study between 1996 and 2002 at the Main University Hospital of Alexandria, Egypt. In 50 patients, we endoscopically measured the length of the vocal process and the distance between the vocal process tip and upper border of the cricoid cartilage. We sagittally and axially sectioned 25 total laryngectomy specimens to verify the position of the arytenoids and their relation to the cricoid. The anatomical findings led to the design of a laser partial arytenoidectomy and cordotomy (L-PAC), which we used in 45 patients with bilateral cord paralysis in adduction.

RESULTS

The anatomical findings showed that the cricoarytenoid joint did not contribute to the airway in any of the measured specimens. Using L-PAC, we decannulated 100% of the patients and no patient needed postoperative tracheostomy at any time. Only 3 patients experienced minimal postoperative aspiration to liquids (6.7%). We achieved reasonable phonation as assessed by a speech analysis battery. However, 3 patients (6.7%) needed contralateral L-PAC.

CONCLUSION

The present extra-articular technique, L-PAC, showed its superiority to previous endoscopic or transcervical complete arytenoidectomy techniques in providing an effective balance between the protective, respiratory, and to a lesser extent the phonatory functions.

Authors+Show Affiliations

Department of Otolaryngology Head and Neck Surgery, University of Alexandria, Al-Ibrahemia, Egypt.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16228052

Citation

Al-Fattah, Hesham A., et al. "Partial Laser Arytenoidectomy in the Management of Bilateral Vocal Fold Immobility. a Modification Based On Functional Anatomical Study of the Cricoarytenoid Joint." Saudi Medical Journal, vol. 26, no. 10, 2005, pp. 1539-45.
Al-Fattah HA, Hamza AH, Gaafar AH, et al. Partial laser arytenoidectomy in the management of bilateral vocal fold immobility. A modification based on functional anatomical study of the cricoarytenoid joint. Saudi Med J. 2005;26(10):1539-45.
Al-Fattah, H. A., Hamza, A. H., Gaafar, A. H., & Tantawy, A. A. (2005). Partial laser arytenoidectomy in the management of bilateral vocal fold immobility. A modification based on functional anatomical study of the cricoarytenoid joint. Saudi Medical Journal, 26(10), 1539-45.
Al-Fattah HA, et al. Partial Laser Arytenoidectomy in the Management of Bilateral Vocal Fold Immobility. a Modification Based On Functional Anatomical Study of the Cricoarytenoid Joint. Saudi Med J. 2005;26(10):1539-45. PubMed PMID: 16228052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Partial laser arytenoidectomy in the management of bilateral vocal fold immobility. A modification based on functional anatomical study of the cricoarytenoid joint. AU - Al-Fattah,Hesham A, AU - Hamza,Ashraf H, AU - Gaafar,Alaa H, AU - Tantawy,Ahmed A, PY - 2005/10/18/pubmed PY - 2006/3/29/medline PY - 2005/10/18/entrez SP - 1539 EP - 45 JF - Saudi medical journal JO - Saudi Med J VL - 26 IS - 10 N2 - OBJECTIVES: To establish the anatomical relationships of the arytenoid and cricoid cartilages and apply these findings to design an arytenoidectomy based on a sound anatomical basis. METHODS: We prospectively conducted this study between 1996 and 2002 at the Main University Hospital of Alexandria, Egypt. In 50 patients, we endoscopically measured the length of the vocal process and the distance between the vocal process tip and upper border of the cricoid cartilage. We sagittally and axially sectioned 25 total laryngectomy specimens to verify the position of the arytenoids and their relation to the cricoid. The anatomical findings led to the design of a laser partial arytenoidectomy and cordotomy (L-PAC), which we used in 45 patients with bilateral cord paralysis in adduction. RESULTS: The anatomical findings showed that the cricoarytenoid joint did not contribute to the airway in any of the measured specimens. Using L-PAC, we decannulated 100% of the patients and no patient needed postoperative tracheostomy at any time. Only 3 patients experienced minimal postoperative aspiration to liquids (6.7%). We achieved reasonable phonation as assessed by a speech analysis battery. However, 3 patients (6.7%) needed contralateral L-PAC. CONCLUSION: The present extra-articular technique, L-PAC, showed its superiority to previous endoscopic or transcervical complete arytenoidectomy techniques in providing an effective balance between the protective, respiratory, and to a lesser extent the phonatory functions. SN - 0379-5284 UR - https://www.unboundmedicine.com/medline/citation/16228052/Partial_laser_arytenoidectomy_in_the_management_of_bilateral_vocal_fold_immobility__A_modification_based_on_functional_anatomical_study_of_the_cricoarytenoid_joint_ DB - PRIME DP - Unbound Medicine ER -