- Outcomes of Prophylactic Epiglottic Petiole Suspension at the Time of Complete Laryngofissure. [Journal Article]
- OHOtolaryngol Head Neck Surg 2019 Jun 11; :194599819852619
- CONCLUSIONS: Patients with PPS had significantly fewer symptoms after complete laryngofissure as compared with patients without PPS. PPS should be considered when a complete laryngofissure is being performed during airway reconstruction.
- Posterior laryngofissure using a surgical contact diode laser: an experimental feasibility study. [Journal Article]
- LMLasers Med Sci 2019 Feb 14
- To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight Landrace pigs (15-20 kg) were anesthetized, intubated,…
To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight Landrace pigs (15-20 kg) were anesthetized, intubated, ventilated, and submitted to a cervical tracheostomy. An anterior and posterior midline longitudinal laryngofissure incision was created according to randomization-control (n = 4), posterior laryngofissure with a scalpel blade; electrocautery (n = 12), posterior laryngofissure by electrocautery (10, 15, 20, 25 W powers); CDL (n = 12), posterior laryngofissure by the CDL (10, 15, 20, 25 W peak powers in pulsed mode). Larynx and proximal trachea were excised, prepared for histopathology, and digital morphometric analysis. Measurements in and within each group were analyzed (Kruskal-Wallis and Dunn test) with a level of significance of p < 0.05. Incision width was not different between the groups, as well as in the powers used in CDL (p = 0.161) and electrocautery group (p = 0.319). The depth of the incisions was smaller in the Laser group compared to control (p = 0.007), and in the electrocautery compared to control (p = 0.026). Incision area was smaller in CDL compared with the control (p = 0.027), and not different between laser and electrocautery groups (p = 0.199). The lateral thermal damage produced by electrocautery was the largest, with a significant difference between laser and electrocautery (p = 0.018), and between electrocautery and control (p = 0.004), whereas the comparison between laser and control showed no significant differences (p = 0.588). The posterior laryngofissure incision using a 980-nm CDL is feasible resulting in smaller incisional area and less lateral thermal damage.
- Factors associated with epiglottic petiole prolapse repositioning success. [Journal Article]
- LLaryngoscope 2018 Dec 25
- CONCLUSIONS: Patients with petiole prolapse have a history of complete laryngofissure and multiple open airway surgeries. Pre-epiglottic fat debulking and longer stent placement at the time of the repositioning surgery appear to significantly increase the long-term success rate.
- Thyroid Cartilage Window Approach to Extract a Foreign Body after Migration into the Paraglottic Space. [Case Reports]
- CRCase Rep Otolaryngol 2018; 2018:3590580
- We report a case of fish bone impaction in the paraglottic space, which caused palsy of the left vocal cord. The patient was a 45-year-old man. He presented with throat pain and hoarseness of voice f…
We report a case of fish bone impaction in the paraglottic space, which caused palsy of the left vocal cord. The patient was a 45-year-old man. He presented with throat pain and hoarseness of voice for approximately one week. The diagnosis was made after careful history taking and confirmed by the use of computed tomography scan as the fish bone was not visible endoscopically under local and general anaesthesia. The patient underwent thyroid cartilage window approach, and the fish bone was retrieved. His symptoms have improved significantly, and he did not require tracheostomy. Other cases reported the removal of foreign bodies by other techniques such as laryngofissure and posterolateral approach. Our case is different in that we used a modification of thyroplasty type 1 technique as it has less reported complications than other approaches that were published in literature.
- Recurrence of Giant Cell Tumor of The Larynx. [Case Reports]
- JCJ Craniofac Surg 2018; 29(3):e230-e232
- Giant cell tumor of the larynx is a rare tumor. It was first reported by Wessely et al in 1940. Thirty-nine cases have been reported until now and together with the current case 2 recurrences were en…
Giant cell tumor of the larynx is a rare tumor. It was first reported by Wessely et al in 1940. Thirty-nine cases have been reported until now and together with the current case 2 recurrences were encountered. In this case report, our aim was to discuss conservative management because of the suspicion of recurrence. A 70-year-old male patient was admitted to our clinic with the complaint of hoarseness. A tumor measuring 1 × 1 cm located in the anterior half right vocal fold and extending to the anterior comissure was found on laryngeal endoscopy. Direct laryngoscopy and biopsy of the mass revealed giant cell tumor on histopathological examination. Tumor resection with cordectomy through laryngofissure and subsequently medialization thyroplasty were performed. Horaseness of the patient improved. On 2-year follow-up, a tumoral lesion suggesting recurrence was found on the vocal cord. Direct laryngoscopy and biopsy confirmed recurrence. Total laryngectomy was performed. This is the second case of recurrent giant cell tumor of the larynx. The therapy of choice should be selected considering the possibility of recurrence.
- Cricoid malformation and endolaryngeal submucosal drilling - a possible technique. [Case Reports]
- JMJ Med Life 2017 Jul-Sep; 10(3):194-196
- Cricoid malformations vary according to their severity and anatomic features. Some of them get a delayed diagnosis in spite of the complex medical care. Objective: To present a case with a laryngeal…
Cricoid malformations vary according to their severity and anatomic features. Some of them get a delayed diagnosis in spite of the complex medical care. Objective: To present a case with a laryngeal malformation and our surgery technique. Material, method: A case presentation of a cannulated child, who previously had a heart surgery, with difficult decannulation.
- Anesthesia management for a case of laryngeal keel placement. [Case Reports]
- SJSaudi J Anaesth 2017 Oct-Dec; 11(4):486-489
- Congenital laryngeal web is a rare anomaly with incidence of 1 in 10,000 births. Its clinical presentation may range from an asymptomatic patient or mild hoarseness of voice to severe respiratory str…
Congenital laryngeal web is a rare anomaly with incidence of 1 in 10,000 births. Its clinical presentation may range from an asymptomatic patient or mild hoarseness of voice to severe respiratory stridor. The primary goals of surgical intervention for congenital laryngeal web are to establish a patent airway and to achieve a good voice quality. As recurrence rate after plain excision of laryngeal web is very high, its removal may be coupled by placement of a silastic keel in between vocal cords. Endolaryngeal placement of a keel is definitely less invasive than laryngofissure, but little is known about its anesthesia management. Frequent ventilatory adjustment and endotracheal tube (ETT) manipulations are needed along with vigilant monitoring. Risk of perforation or accidental dislodgment of the ETT and laryngeal edema are other concerns in management. We report a case.
- A Misdiagnosed Laryngeal Web: Treated with an Innovative Self-Made Keel. [Case Reports]
- JCJ Clin Diagn Res 2017; 11(5):MD04-MD06
- Laryngeal web is a rare congenital anomaly. Late presentation at the age of 10 years as in our case, with misleading diagnosis of asthma in a Cohen's type III glottic web is even rarer. In cases of c…
Laryngeal web is a rare congenital anomaly. Late presentation at the age of 10 years as in our case, with misleading diagnosis of asthma in a Cohen's type III glottic web is even rarer. In cases of congenital laryngeal web the aim is to provide a patent airway and to achieve a good voice quality. Regardless of the technique used; the primary concern is recurrence. Traditionally, the treatment of choice for laryngeal web was laryngofissure with placement of a keel however; endoscopic laser excision of the web with keel placement is now the preferred technique for thin anterior glottic webs. This endoscopic technique not only requires a Lichtenberger needle carrier but also the ready-made keel, which many of the government set-ups in our country cannot provide. For an alternative to this problem, we have described an innovative, minimally invasive technique for placement of a self-made silicone keel without any sophisticated instruments.
- Prognostic role of margin status in open and CO2 laser cordectomy for T1a-T1b glottic cancer. [Journal Article]
- BJBraz J Otorhinolaryngol 2016 Dec 24
- CONCLUSIONS: Margin status has a prognostic role in T1a-T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes.
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- Challenges in the Management of Laryngeal Stenosis. [Journal Article]
- IJIndian J Otolaryngol Head Neck Surg 2016; 68(3):294-9
- Laryngeal stenosis is one of the most complex and challenging problems in the field of head and neck surgery. The management involves a multidisciplinary approach with multiple complex procedures. In…
Laryngeal stenosis is one of the most complex and challenging problems in the field of head and neck surgery. The management involves a multidisciplinary approach with multiple complex procedures. In this study we discuss our experience of laryngeal stenosis with regards to patient characteristics, cause and management. A retrospective analysis of 35 patients of laryngeal stenosis treated at a tertiary care centre was evaluated. Inclusion criteria were all patients with laryngeal stenosis who required surgical intervention. Exclusion criteria were patients with associated tracheal stenosis and laryngeal stenosis due to cancer. Demographic data was recorded and findings relating to aetiology, characteristics of stenosis and the various aspects of therapeutic procedures performed are discussed with review of literature. Among 35 patients, 24 were males and 11 females of the age group 2-79 years. 2 (5.7 %) patients had supraglottic stenosis, 11 (31.4 %) had glottis stenosis, 16 (45.7 %) had subglottic stenosis and 6 (17.1 %) had combined multiple sites stenosis. Each patient underwent an average of 3.22 surgical procedures like microlaryngoscopy and excision with cold instrument, CO2 laser excision or open procedures like laryngofissure and excision and laryngoplasty. Montgomery t tube insertion was a common procedure in 17 patients (48.6 %). Of the total 35 patients with severe LS, 27 (77.1 %) patients were successfully decanulated. The results of glottic (100 %) and supraglottic stenosis (100 %) are excellent as compared to subglottic (68.8 %) and combined stenosis (50 %) of multiple sites. Laryngeal stenosis with airway compromise causes significant morbidity to the patients and is a difficult condition to treat in both adult and pediatric population. The need for multiple surgical procedures is common in the treatment of laryngeal stenosis with the t-tube being an important aid in the management of this condition. Trauma especially post intubation trauma is the commonest cause of laryngeal stenosis and the involvement of subglottis has poor outcome as compared to other subsites.