In vitro comparison of 3 techniques of prosthesis attachment to the muscular process of the equine arytenoid cartilage

Ahern, Benjamin J.; Eps, A. W. van; Boston, Raymond C.; Franklin, Samantha

doi:10.1111/vsu.12659

Cited by 7 publications

(12 citation statements)

References 33 publications

(48 reference statements)

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“…In a live animal, the arytenoid would be subject to adduction forces during coughing, swallowing, or negative airway pressures. Placement of an anchor in the arytenoid has been found to reduce the load on the LP suture by approximately 50%, potentially further mitigating the effect of these forces . The DLPS could therefore be less effective in vivo than seen in this in vitro study, warranting further evaluation .…”

Section: Discussionmentioning

confidence: 76%

“…15,[22][23][24] A similar means of in vitro testing using LRQ has been previously reported. 19,23 Cross-sectional area of the rima glottis would have been an alternative method of measuring arytenoid abduction comparatively but based on previous research comparing the two methods there is no significant difference and, due to the simplicity and robustness of LRQ measurements, this was selected. 22 The first phase of this study was designed to assess the shortening required to maximize arytenoid abduction and serve as a frame of reference for the results of phase 2 testing.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to the use of an anchor in the arytenoid which has been shown to reduce the load on the laryngoplasty suture by approximately 50%, the exact effect of these forces is as yet undetermined. 19 In a live animal, the arytenoid would be subject to adduction forces during coughing, swallowing, or negative airway pressures. Placement of an anchor in the arytenoid has been found to reduce the load on the LP suture by approximately 50%, potentially further mitigating the effect of these forces.…”

Section: Discussionmentioning

confidence: 99%

“…The right arytenoid of each larynx was maximally abducted and fixed in position for all testing, as previously reported, 19,20 by using a standard LP technique with a single strand of No. 5 Ethibond Excel (7 metric; V-37; Ethicon, Cornelia, Georgia).…”

Section: Laryngoplastymentioning

confidence: 99%

“…For the arytenoid attachment, the FAS-TakII suture anchor was placed in the arytenoid 10 mm cranial to the insertion of the CAD muscle, as previously described. 19,21 Specifically, the anchor was directed from a slightly dorsolateral to ventromedial direction to engage the mid portion of the muscular process. The suture was then threaded through the eyelet of the anchor from medial to lateral such that the 2 thread ends were in a relatively lateral position creating a single suture loop.…”

Section: Laryngoplastymentioning

confidence: 99%

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In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction

et al. 2018

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Laryngoplastymentioning

confidence: 99%

Section: Laryngoplastymentioning

confidence: 99%

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In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction

et al. 2018

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Evaluation of a prototype dynamic laryngoplasty system in vitro with an equine vacuum airflow system

et al. 2018

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Objective: To evaluate a prototype dynamic laryngoplasty system (DLPS) in a static airflow model. Study design: Experimental. Sample population: Ten equine larynges. Methods: The right arytenoid was fixed in abduction in all specimens. A left-sided laryngoplasty was performed with No. 2 Fiberwire and a FASTakII anchor. Each larynx was tested in a static airflow model. The system was adjusted to a flow rate of 55 L/s and prelaryngeal pressure of 12 mm Hg prior to testing in maximal arytenoid abduction. In phase 1, the left suture was loosened, shortened, and tested in 3-mm steps from 0 to 30 mm. In phase 2, the suture was tied with the DLPS in position at a target left-to-right quotient angle (LRQ) of 0.5. The DLPS was activated to target psi of 0, 25, and 50 for testing. Translaryngeal impedance (TLI), LRQ, cross-sectional areas (CSA), and resultant change in LRQ and CSA between, before, and during airflow testing were calculated. Results: In phase 1, TLI was reduced by suture shortening up to 6 mm (P = .001) but not by additional shortening (P > .05). In phase 2, activation of the DLPS reduced the TLI from 0 psi (0.43 ± 0.08 mm Hg/L/s) to 25 psi (0.16 ± 0.04 mm Hg/L/s, P < .001), but no further reduction was detected at maximal psi (P = .10). Conclusion: Activation of the DLPS effectively reduced TLI. Clinical significance: These results justify further investigation of the DLPS to assess its clinical applicability.

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The effect of repeated freezing and thawing on the suture pull‐out strength in equine arytenoid and cricoid cartilages

et al. 2022

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Objective To assess the effect of repeated freezing and thawing on the suture pull‐out strength in arytenoid and cricoid cartilages subjected to the laryngoplasty (LP) procedure. Study design Ex vivo experimental study. Sample population Ten grossly normal equine cadaveric larynges. Methods Bilateral LP constructs were created using a standard LP technique. One hemilarynx was randomly allocated to the single freeze and thaw group and the other allocated to the repeated freeze and thaw (3 complete cycles) group. The suture ends of each LP construct were attached to a load frame and subjected to monotonic loading until construct failure. Mean load (N) and displacement (mm) at LP construct failure were compared between groups. Results All LP constructs failed by suture pull through the arytenoid cartilage. The mean load at failure was similar between groups (118.9 ± 25.5 N in the single freeze and thaw group and 113.4 ± 20.5 N in the repeated freeze and thaw group, P = .62). The mean displacement at failure was similar between groups (54.4 ± 15.1 mm in the single freeze and thaw group and 54.4 ± 15.4 mm in the repeated freeze and thaw group, P = .99). Conclusion Repeated freezing and thawing did not affect the suture pullout strength of the arytenoid and cricoid cartilages. Clinical significance Laryngeal specimens that have been subjected to repeated freezing and thawing can be utilized in the experimental evaluation of LP procedures because there is no alteration of the suture pull‐out strength of the relevant cartilages.

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In vitro comparison of 3 techniques of prosthesis attachment to the muscular process of the equine arytenoid cartilage

Abstract: Use of the FASTak II anchor may decrease the suture load required to achieve arytenoid abduction in clinical cases. This may reduce the load placed on the laryngoplasty, thereby, minimizing postoperative loss of abduction.

Cited by 7 publications

References 33 publications

In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction

In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction

Evaluation of a prototype dynamic laryngoplasty system in vitro with an equine vacuum airflow system

The effect of repeated freezing and thawing on the suture pull‐out strength in equine arytenoid and cricoid cartilages

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