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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.
Otolaryngol Head Neck Surg. 2006 Feb; 134(2):294-301.OH

Abstract

OBJECTIVE

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

STUDY DESIGN

In 50 patients the length of the vocal process and the distance between vocal process tip and upper border of the cricoid cartilage were endoscopically measured. Twenty-five total laryngectomy specimens were sagittally and axially sectioned to verify the position of the arytenoids and their relation to the cricoid. The anatomical findings led to the design of laser partial arytenoidectomy and cordotomy (L-PAC), which was 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, 100% of the patients were decannulated and no patient needed a postoperative tracheostomy at any time. Only 3 patients experienced minimal postoperative aspiration to liquids (6.7%). Reasonable phonation was achieved as regarded by a speech analysis battery. Three patients (6.7%) needed a contralateral L-PAC.

CONCLUSIONS

The shape of the cricoid and the location of its axis of maximum width ought to dictate the technique of glottic widening to be used in bilateral cord immobility in adduction. The present extra-articular technique, L-PAC, showed its versatility in providing an effective balance between the protective, the respiratory, and to lesser extent the phoniatory functions.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16455380

Citation

Al-Fattah, Hesham Abd, et al. "Partial Laser Arytenoidectomy in the Management of Bilateral Vocal Fold Immobility: a Modification Based On Functional Anatomical Study of the Cricoarytenoid Joint." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 134, no. 2, 2006, pp. 294-301.
Al-Fattah HA, Hamza A, Gaafar 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. Otolaryngol Head Neck Surg. 2006;134(2):294-301.
Al-Fattah, H. A., Hamza, A., Gaafar, A., & Tantawy, A. (2006). Partial laser arytenoidectomy in the management of bilateral vocal fold immobility: a modification based on functional anatomical study of the cricoarytenoid joint. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 134(2), 294-301.
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. Otolaryngol Head Neck Surg. 2006;134(2):294-301. PubMed PMID: 16455380.
* 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 Abd, AU - Hamza,Ashraf, AU - Gaafar,Alaa, AU - Tantawy,Ahmed, PY - 2004/12/10/received PY - 2006/2/4/pubmed PY - 2006/3/16/medline PY - 2006/2/4/entrez SP - 294 EP - 301 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 134 IS - 2 N2 - OBJECTIVE: To establish the anatomical relationships between the arytenoid and cricoid cartilages and apply these findings to design an arytenoidectomy based on a sound anatomical basis. STUDY DESIGN: In 50 patients the length of the vocal process and the distance between vocal process tip and upper border of the cricoid cartilage were endoscopically measured. Twenty-five total laryngectomy specimens were sagittally and axially sectioned to verify the position of the arytenoids and their relation to the cricoid. The anatomical findings led to the design of laser partial arytenoidectomy and cordotomy (L-PAC), which was 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, 100% of the patients were decannulated and no patient needed a postoperative tracheostomy at any time. Only 3 patients experienced minimal postoperative aspiration to liquids (6.7%). Reasonable phonation was achieved as regarded by a speech analysis battery. Three patients (6.7%) needed a contralateral L-PAC. CONCLUSIONS: The shape of the cricoid and the location of its axis of maximum width ought to dictate the technique of glottic widening to be used in bilateral cord immobility in adduction. The present extra-articular technique, L-PAC, showed its versatility in providing an effective balance between the protective, the respiratory, and to lesser extent the phoniatory functions. SN - 0194-5998 UR - https://www.unboundmedicine.com/medline/citation/16455380/Partial_laser_arytenoidectomy_in_the_management_of_bilateral_vocal_fold_immobility:_a_modification_based_on_functional_anatomical_study_of_the_cricoarytenoid_joint_ L2 - https://journals.sagepub.com/doi/10.1016/j.otohns.2005.08.028?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -