Localization of the muscular process for arytenoid adduction surgery

Mitchell, Joshua R.; McRae, Bryan R.; Halum, Stacey L.

doi:10.1002/lary.20152

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…In AA surgery, identifying the location of the MP is important for both safety and success, and several reports have described less invasive methods for identifying the MP. 2, 11, 12 In EAAS, the most difficult tasks are aiming the penetration needle at the MP during its insertion through the cricothyroid space and intraluminal penetration of the piriform sinus. These tasks could result in failure or complications such as hematoma, mucosal laceration, and penetration of the endotracheal tube, especially when the procedure is performed by inexperienced surgeons.…”

Section: Discussionmentioning

confidence: 99%

A new and less invasive procedure for arytenoid adduction surgery

Murata¹,

Yasuoka²,

Shimada³

et al. 2011

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

A new and less invasive procedure for arytenoid adduction surgery

Murata¹,

Yasuoka²,

Shimada³

et al. 2011

The Laryngoscope

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“…A cadaveric study by Mitchell et al found that the muscular process was located along a line extending posteriorly from the inferior border of a standard laryngoplasty window. 86 In males, the average distance was 27mm, whereas in females the distance was 19mm. The muscular process was consistently found an average of 2.7mm inferior to the midpoint between the roots of the superior and inferior cornu.…”

Section: Surgical Approachmentioning

confidence: 99%

“…101,102 Although commonly cited as a complication of arytenoid adduction, it is rarely reported in the literature. 66,86,88,94 …”

Section: Complicationsmentioning

confidence: 99%

Framework Surgery for Treatment of Unilateral Vocal Fold Paralysis

Daniero

Garrett

Francis

2014

Curr Otorhinolaryngol Rep

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Laryngeal framework surgery is the current gold standard treatment for unilateral vocal fold paralysis. It provides a permanent solution to glottic insufficiency caused by injury to the recurrent laryngeal nerve. Various modifications to the original Isshiki type I laryngoplasty procedure have been described to improve voice and swallowing outcomes. The success of this procedure is highly dependent on the experience of the surgeon as it epitomizes the intersection of art and science in the field. The following article reviews the evidence, controversies, and complications related to laryngoplasty for unilateral vocal fold paralysis. It also provides a detailed analysis of how and when arytenoid-positioning procedures should be considered, and summarizes the literature on postoperative outcomes.

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“…When AA was first performed, a method for identifying the arytenoid cartilage was proposed based on anatomical studies. 12,13 To identify the arytenoid cartilage based on anatomical landmarks, it is necessary to remove the external laryngeal muscle and expose the thyroid cartilage plate. However, the external laryngeal muscles, pharyngeal constrictor muscles, external branch of the superior laryngeal nerve, and cricothyroid muscle function are auxiliary and compensatory for paralyzed vocal folds, whose function is reduced because of damage to the recurrent laryngeal nerve.…”

Section: Arytenoid Cartilage Positionmentioning

confidence: 99%

Investigation of the Position and Angle of the Vocal Fold Projected onto the Thyroid Cartilage

Matsushima

2024

The Laryngoscope

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ObjectiveTo perform laryngeal framework surgery for unilateral vocal fold paralysis and obtain favorable voice improvement, it is necessary to accurately determine the vocal fold and arytenoid cartilage positions. Thus, the position and angle of the paralyzed vocal folds and arytenoid cartilage projected onto the affected thyroid plate were measured using computed tomography (CT) before and after surgery.MethodsForty‐six male patients with thyroid cartilage ossification observed on preoperative CT and vocal fold paralysis were included. Using Adobe Illustrator®, the thyroid plate on the affected side was reconstructed from the continuous images of the sagittal section of the CT examination during participant's quiet breathing (reconstructed affected thyroid plate [RATP]).ResultsThe anterior commissure mean position was slightly cranial to the midpoint of the thyroid cartilage midline. The paralyzed vocal fold angle was not parallel to the baseline. The average unaffected vocal fold angle during vocalization projected onto the affected thyroid plate was 13.83°, which differed significantly from the average paralyzed vocal fold angle before surgery (19.05°). However, no significant difference was observed in comparison with the average angle of the paralyzed vocal fold after arytenoid adduction. The average distance from the inferior notch of the affected side thyroid cartilage to the affected arytenoid cartilage was 16.7 mm.ConclusionBy understanding the positional relationship between the thyroid cartilage plate and internal structure from preoperative CT images, more effective surgery can be performed according to individual differences.Level of EvidenceIV Laryngoscope, 2024

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Localization of the muscular process for arytenoid adduction surgery

Abstract: The TTI window can be used intraoperatively to help locate the arytenoid muscular process during arytenoid adduction surgery.

Cited by 8 publications

References 11 publications

A new and less invasive procedure for arytenoid adduction surgery

A new and less invasive procedure for arytenoid adduction surgery

Framework Surgery for Treatment of Unilateral Vocal Fold Paralysis

Investigation of the Position and Angle of the Vocal Fold Projected onto the Thyroid Cartilage

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