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Endoscopic arytenoid lateropexy for isolated posterior glottic stenosis.
Laryngoscope. 2008 Sep; 118(9):1550-5.L

Abstract

OBJECTIVES/HYPOTHESIS

A posterior glottic stenosis (PGS) may limit the abduction of the arytenoid cartilages. One option for the treatment of dyspnea in lower grade stenoses is endoscopic laterofixation of the vocal cords after scar excision. In our prospective study, we assess a refined method for effective endoscopic mobilization and lateropexy of the arytenoid cartilages.

STUDY DESIGN AND METHODS

Thirty-two consecutive patients with PGS underwent surgery. Endoscopically, the scar between the arytenoid cartilages was transected with a CO2 laser. The scars that had spread into the cricoarytenoid joint were transected with a right-angled endolaryngeal scythe designed for this purpose. The lateropexy of the adequately mobilized arytenoid cartilages was performed with a reinforced Lichtenberger's needle carrier instrument, with consideration of the real abduction of the cricoarytenoid joint.

RESULTS

Twenty-eight patients achieved an excellent breathing ability, only effort dyspnea remained in three cases. One patient could not be decannulated due to aspiration. The early postoperative improvement in the airway function test results showed no relationship with the grade of stenoses. However, in cases of higher grade stenoses with bilateral joint damage, the later postoperative airway function results had decreased slightly. In 25 cases, phonation significantly improved after the removal of the fixing sutures.

CONCLUSIONS

After proper mobilization, endoscopic arytenoid lateropexy can be considered as a minimally invasive function-preserving procedure even for severe PGS. This treatment option provides stable improvements in breathing ability and good voice quality without the need for tracheostomy.

Authors+Show Affiliations

Department of Otorhinolaryngology and Head & Neck Surgery, Medical Faculty of the Szeged University, Szeged, Hungary. rovo@invitel.huNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18677281

Citation

Rovó, László, et al. "Endoscopic Arytenoid Lateropexy for Isolated Posterior Glottic Stenosis." The Laryngoscope, vol. 118, no. 9, 2008, pp. 1550-5.
Rovó L, Venczel K, Torkos A, et al. Endoscopic arytenoid lateropexy for isolated posterior glottic stenosis. Laryngoscope. 2008;118(9):1550-5.
Rovó, L., Venczel, K., Torkos, A., Majoros, V., Sztanó, B., & Jóri, J. (2008). Endoscopic arytenoid lateropexy for isolated posterior glottic stenosis. The Laryngoscope, 118(9), 1550-5. https://doi.org/10.1097/MLG.0b013e31817c0b32
Rovó L, et al. Endoscopic Arytenoid Lateropexy for Isolated Posterior Glottic Stenosis. Laryngoscope. 2008;118(9):1550-5. PubMed PMID: 18677281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic arytenoid lateropexy for isolated posterior glottic stenosis. AU - Rovó,László, AU - Venczel,Kincsõ, AU - Torkos,Attila, AU - Majoros,Valéria, AU - Sztanó,Balázs, AU - Jóri,József, PY - 2008/8/5/pubmed PY - 2008/9/17/medline PY - 2008/8/5/entrez SP - 1550 EP - 5 JF - The Laryngoscope JO - Laryngoscope VL - 118 IS - 9 N2 - OBJECTIVES/HYPOTHESIS: A posterior glottic stenosis (PGS) may limit the abduction of the arytenoid cartilages. One option for the treatment of dyspnea in lower grade stenoses is endoscopic laterofixation of the vocal cords after scar excision. In our prospective study, we assess a refined method for effective endoscopic mobilization and lateropexy of the arytenoid cartilages. STUDY DESIGN AND METHODS: Thirty-two consecutive patients with PGS underwent surgery. Endoscopically, the scar between the arytenoid cartilages was transected with a CO2 laser. The scars that had spread into the cricoarytenoid joint were transected with a right-angled endolaryngeal scythe designed for this purpose. The lateropexy of the adequately mobilized arytenoid cartilages was performed with a reinforced Lichtenberger's needle carrier instrument, with consideration of the real abduction of the cricoarytenoid joint. RESULTS: Twenty-eight patients achieved an excellent breathing ability, only effort dyspnea remained in three cases. One patient could not be decannulated due to aspiration. The early postoperative improvement in the airway function test results showed no relationship with the grade of stenoses. However, in cases of higher grade stenoses with bilateral joint damage, the later postoperative airway function results had decreased slightly. In 25 cases, phonation significantly improved after the removal of the fixing sutures. CONCLUSIONS: After proper mobilization, endoscopic arytenoid lateropexy can be considered as a minimally invasive function-preserving procedure even for severe PGS. This treatment option provides stable improvements in breathing ability and good voice quality without the need for tracheostomy. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/18677281/Endoscopic_arytenoid_lateropexy_for_isolated_posterior_glottic_stenosis_ DB - PRIME DP - Unbound Medicine ER -