Morphometic cadaveric analysis of thyroid cartilage in Indian adults with comparative review of studies on other ethnic population

Sahoo, Satyanjaya; Mallick, Ajay; Sethi, Ashwani; Joshi, Himanshu; Ghotra, Aroma

doi:10.18203/issn.2454-5929.ijohns20210158

Cited by 3 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Type I thyroplasty is a widely accepted treatment for UVFP. However, variations in thyroid cartilage dimensions between different ethnic groups, sexes, and individuals 19,20 make it difficult to standardize procedures, especially if the implant shape, 21 dimensions, and site cannot be determined prior to the surgery, leading to discrepancies in results. 22 Imaging studies, such as preoperative CT-scans 23 or digital volume tomography, 24 have been proposed for planning MT procedures to individually customize implants.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis

et al. 2021

View full text Add to dashboard Cite

Objectives/Hypothesis: Evaluation of the clinical outcomes after 6 months of treatment with a novel adjustable implant, the APrevent ® Vocal-Implant-System (VOIS), in conjunction with medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis.Study Design: Prospective case series study at single tertiary referral center.Methods: Preoperative and 1 week, 7 weeks, and 6 months postoperative glottal efficiency (maximum phonation time [MPT]), voice quality (including GRBAS-scores and acoustic parameters) and self-perceived voice-related handicap (voice handicap index [VHI-30]) were measured and analyzed, whereas type of vocal fold closure was evaluated and determined by flexible videolaryngoscopy based on Södersten and Lindestad classification (Wilcoxon signed-rank test).Results: Thirteen patients underwent MT with VOIS under local anesthesia. Six months after surgery, the VHI-30 and MPT had improved from a preoperative mean of 75.0 AE 22.9 and 2.7 AE 2.1 s to a postoperative mean of 20.6 AE 19.7 and 6.3 AE 4.0 s, respectively. The mean GRBAS score improved from preoperative scores of G preop = 2.7, R preop = 2.6, B preop = 2.6, A preop = 2.2, and S preop = 2.0 to G postop = 0.3, R postop = 0.3, B postop = 0.2, A postop = 0.2, and S postop = 0.3 at 6 months postoperatively. Improved glottal closure was achieved in all patients (n = 13). Five patients received postoperative adjustment for the optimization of voice quality and glottal closure. No intra-or postoperative complications were observed. Significant improvements in acoustic parameters, including percentage jitter, percentage shimmer, and signal-to-noise ratio, were also observed after MT. All results were statistically significant (P < .05, Cohen's d > .8).Conclusions: APrevent ® VOIS-Implantation is a safe procedure with good voice outcomes. Postoperative adjustments can be performed smoothly to optimize voice quality and glottal closure.

show abstract

Section: Discussionmentioning

confidence: 99%

Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Medialization thyroplasty is highly dependent on using laryngeal morphometric data as landmarks during surgery. However, morphometric studies have shown variations in thyroid cartilage dimensions due to individual anatomy, ethnical or sexual dimorphism 16,17 . These variations may lead to difficulties in implant placement with inadequate posterior medialization and procedure standardization with a static implant 14 .…”

Section: Discussionmentioning

confidence: 99%

“…However, morphometric studies have shown variations in thyroid cartilage dimensions due to individual anatomy, ethnical or sexual dimorphism. 16 , 17 These variations may lead to difficulties in implant placement with inadequate posterior medialization and procedure standardization with a static implant. 14 Therefore, the pre‐ and postoperative adjustability of the VOIS‐Implant with individualized implant size, making standardization of the surgical procedure possible, can be helpful and beneficial to patients and health care providers.…”

Section: Discussionmentioning

confidence: 99%

Pre‐clinical evaluation of APrevent® VOIS for unilateral vocal fold paralysis medialization

Rast²,

Hsieh

et al. 2023

Laryngoscope Investig Oto

View full text Add to dashboard Cite

Objective To evaluate the concept and efficacy of an adjustable implant (Prototype SH30: porcine implant and APrevent® VOIS: human concept) for treatment of unilateral vocal fold paralysis (UVFP) via in vivo mini‐pig studies, human computed tomographic (CT) and magnetic resonance (MR) image analysis, ex‐vivo aerodynamic and acoustic analysis. Methods Feasibility testing and prototype implantation were performed using in‐vivo UVFP porcine model (n = 8), followed by a dimensional finding study using CT and MR scans of larynges (n = 75) for modification of the implant prototypes. Acoustic and aerodynamic measurements were recorded on excised canine (n = 7) larynges with simulated UVFP before and after medialization with VOIS‐Implant. Results The prototype showed in the in‐vivo UVFP porcine model an improved glottic closure from grade 6 incomplete closure to complete closure (n = 5), to grade 2 incomplete closure (n = 2) and grade 3 incomplete closure (n = 1). On human CT/MR scans the identification of the correct size was successful in 97.3% using the thyroid cartilage alar “distance S” as the only parameter, which is an important step towards procedure standardization and implant design. Results were confirmed with implantation in human laryngeal cadavers (n = 44). Measurements of the acoustic and aerodynamic effects after implantation showed a significant decreased phonation threshold pressure (p = .0187), phonation threshold flow (p = .0001) and phonation threshold power (p = .0046) on excised canine larynges with simulated UVFP. Percent jitter and percent shimmer decreased (p = .2976; p = .1771) but not significant. Conclusions Based on the preclinical results four sizes, differing in medial length, implant width and expansion direction of silicone cushions, seem to be enough to satisfy laryngeal size variations. This concept is significantly effective in medializing UVFP and improving the aerodynamic and acoustic qualities of phonation as reported in a preliminary clinical outcome study with long‐term implantation. Level of Evidence N/A

show abstract

Review of Thyroid Cartilage Compression of the Vertebral Artery

Kong

2024

JSRP

View full text Add to dashboard Cite

Thyroid cartilage compression of the Vertebral Artery (VA) has been implicated as a rare cause of Rotational Vertebral Artery Occlusion (RVAO). 10 cases have been reported in the literature. This has a higher tendency to affect males and younger patients than other forms of stroke. Patients present with multiple episodes prior to diagnosis. Radiologic studies prove crucial for confirming this condition. An aberrant VA course appears to be a necessary factor. All cases suffer from right side VA compression by the superior thyroid cornu. Conservative therapy with antiplatelet treatment is employed commonly. Most patients have definitive treatment with surgical resection of the right superior thyroid cornu. Theories proposed for these characteristics include VA dominance, structural variability in the thyroid cartilage between genders and also variable thyroid cartilage ossification. Given these findings, we propose the term “thyro-vertebral artery syndrome” for this condition.

show abstract

Morphometic cadaveric analysis of thyroid cartilage in Indian adults with comparative review of studies on other ethnic population

Cited by 3 publications

References 4 publications

Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis

Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis

Pre‐clinical evaluation of APrevent® VOIS for unilateral vocal fold paralysis medialization

Review of Thyroid Cartilage Compression of the Vertebral Artery

Contact Info

Product

Resources

About