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A new thread guide instrument for endoscopic arytenoid lateropexy.
Laryngoscope. 2010 Oct; 120(10):2002-7.L

Abstract

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.

Authors+Show Affiliations

Department of Otorhinolaryngology and Head and Neck Surgery , Faculty of Medicine, University of Szeged, Szeged, Hungary. office@orl.szote.u-szeged.huNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20824739

Citation

Rovó, László, et al. "A New Thread Guide Instrument for Endoscopic Arytenoid Lateropexy." The Laryngoscope, vol. 120, no. 10, 2010, pp. 2002-7.
Rovó L, Madani S, Sztanó B, et al. A new thread guide instrument for endoscopic arytenoid lateropexy. Laryngoscope. 2010;120(10):2002-7.
Rovó, L., Madani, S., Sztanó, B., Majoros, V., Smehák, G., Szakács, L., & Jóri, J. (2010). A new thread guide instrument for endoscopic arytenoid lateropexy. The Laryngoscope, 120(10), 2002-7. https://doi.org/10.1002/lary.21055
Rovó L, et al. A New Thread Guide Instrument for Endoscopic Arytenoid Lateropexy. Laryngoscope. 2010;120(10):2002-7. PubMed PMID: 20824739.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new thread guide instrument for endoscopic arytenoid lateropexy. AU - Rovó,László, AU - Madani,Shahram, AU - Sztanó,Balázs, AU - Majoros,Valéria, AU - Smehák,György, AU - Szakács,László, AU - Jóri,József, PY - 2010/9/9/entrez PY - 2010/9/9/pubmed PY - 2010/10/30/medline SP - 2002 EP - 7 JF - The Laryngoscope JO - Laryngoscope VL - 120 IS - 10 N2 - 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. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/20824739/A_new_thread_guide_instrument_for_endoscopic_arytenoid_lateropexy_ DB - PRIME DP - Unbound Medicine ER -