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Excised larynx evaluation of subthyroid cartilage approach to medialization thyroplasty.
Laryngoscope. 2018 03; 128(3):675-681.L

Abstract

OBJECTIVES/HYPOTHESIS

To describe an alternative approach to medialization thyroplasty involving dissection underneath the thyroid cartilage with placement of a Gore-Tex implant, and to evaluate its effect on a range of phonatory measures using an excised canine larynx model.

STUDY DESIGN

Animal model.

METHODS

On each of eight excised canine larynges, the conditions of normal, paralysis, medialization thyroplasty by standard transthyroid cartilage approach, and medialization thyroplasty by experimental subthyroid cartilage approach were performed. Aerodynamic, acoustic, and mucosal wave parameters were measured for each condition.

RESULTS

Compared to the vocal fold paralysis state, both the transthyroid and subthyroid approaches for Gore-Tex insertion resulted in significant decreases in phonation threshold pressure and phonation threshold flow. Both approaches also significantly decreased percent jitter, decreased percent shimmer, and improved signal-to-noise ratio. The mucosal wave was preserved after insertion of the Gore-Tex implant for both approaches. For all the phonatory measures except phonation threshold flow, there were no significant differences between the transthyroid and subthyroid approaches.

CONCLUSIONS

Gore-Tex implantation via a subthyroid approach in an excised canine larynx model can produce effective medialization, preserve the mucosal wave, and significantly improve aerodynamic and acoustic parameters without meaningful difference compared to a traditional transthyroid approach. The subthyroid approach does not require creation of a thyroid cartilage window and could be a potentially valuable alternative method of performing medialization thyroplasty.

LEVEL OF EVIDENCE

NA. Laryngoscope, 128:675-681, 2018.

Authors+Show Affiliations

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28891238

Citation

Thompson, James D., et al. "Excised Larynx Evaluation of Subthyroid Cartilage Approach to Medialization Thyroplasty." The Laryngoscope, vol. 128, no. 3, 2018, pp. 675-681.
Thompson JD, Hoffman MR, Scholp A, et al. Excised larynx evaluation of subthyroid cartilage approach to medialization thyroplasty. Laryngoscope. 2018;128(3):675-681.
Thompson, J. D., Hoffman, M. R., Scholp, A., Devine, E. E., Jiang, J. J., & McCulloch, T. M. (2018). Excised larynx evaluation of subthyroid cartilage approach to medialization thyroplasty. The Laryngoscope, 128(3), 675-681. https://doi.org/10.1002/lary.26852
Thompson JD, et al. Excised Larynx Evaluation of Subthyroid Cartilage Approach to Medialization Thyroplasty. Laryngoscope. 2018;128(3):675-681. PubMed PMID: 28891238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Excised larynx evaluation of subthyroid cartilage approach to medialization thyroplasty. AU - Thompson,James D, AU - Hoffman,Matthew R, AU - Scholp,Austin, AU - Devine,Erin E, AU - Jiang,Jack J, AU - McCulloch,Timothy M, Y1 - 2017/09/11/ PY - 2017/06/06/received PY - 2017/07/24/accepted PY - 2017/9/12/pubmed PY - 2018/10/12/medline PY - 2017/9/12/entrez KW - Gore-Tex implant KW - Medialization thyroplasty KW - excised canine larynx model KW - subthyroid approach KW - vocal fold paralysis SP - 675 EP - 681 JF - The Laryngoscope JO - Laryngoscope VL - 128 IS - 3 N2 - OBJECTIVES/HYPOTHESIS: To describe an alternative approach to medialization thyroplasty involving dissection underneath the thyroid cartilage with placement of a Gore-Tex implant, and to evaluate its effect on a range of phonatory measures using an excised canine larynx model. STUDY DESIGN: Animal model. METHODS: On each of eight excised canine larynges, the conditions of normal, paralysis, medialization thyroplasty by standard transthyroid cartilage approach, and medialization thyroplasty by experimental subthyroid cartilage approach were performed. Aerodynamic, acoustic, and mucosal wave parameters were measured for each condition. RESULTS: Compared to the vocal fold paralysis state, both the transthyroid and subthyroid approaches for Gore-Tex insertion resulted in significant decreases in phonation threshold pressure and phonation threshold flow. Both approaches also significantly decreased percent jitter, decreased percent shimmer, and improved signal-to-noise ratio. The mucosal wave was preserved after insertion of the Gore-Tex implant for both approaches. For all the phonatory measures except phonation threshold flow, there were no significant differences between the transthyroid and subthyroid approaches. CONCLUSIONS: Gore-Tex implantation via a subthyroid approach in an excised canine larynx model can produce effective medialization, preserve the mucosal wave, and significantly improve aerodynamic and acoustic parameters without meaningful difference compared to a traditional transthyroid approach. The subthyroid approach does not require creation of a thyroid cartilage window and could be a potentially valuable alternative method of performing medialization thyroplasty. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:675-681, 2018. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/28891238/Excised_larynx_evaluation_of_subthyroid_cartilage_approach_to_medialization_thyroplasty_ L2 - https://doi.org/10.1002/lary.26852 DB - PRIME DP - Unbound Medicine ER -