Recent Modifications in Thyroplasty Type I

Isshiki, Nobuhiko; Kojima, Hisayoshi; Taira, Tatsuzo; Shoji, Kazuhiko

doi:10.1177/000348948909801005

Cited by 101 publications

(63 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, efforts to prevent RLN damage as well as to assess RLNP promptly are essential for the postoperative management of patients undergoing an esophagectomy. The generally accepted management methods for patients with URLNP are observation for several months after surgery, intracordal injection (Graboyes et al 2011), type I thyroplasty (Isshiki et al 1989;Schneider et al 2003), arytenoids adduction (Isshiki et al 1978), and laryngeal reinnervation. In cases with RLN involvement via metastatic nodes, the RLN is sometimes resected together with metastatic nodes to enable a curative operation (Tachimori et al 1995).…”

Section: Introductionmentioning

confidence: 99%

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Koyanagi

Igaki

Iwabu

et al. 2015

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Recurrent laryngeal nerve paralysis (RLNP) after esophagectomy is a common complication and associated with aspiration pneumonia. In this study, we assessed the risk of RLNP and the usefulness of immediate reconstruction of recurrent laryngeal nerve (RLN) to prevent respiratory complications after esophagectomy. Seven hundred and eighty-two consecutive patients underwent an esophagectomy with three-field lymph node dissection, simultaneous gastric conduit reconstruction, and cervical anastomosis. Vocal cord function was observed using a flexible laryngoscope. Reconstruction between RLN and ipsilateral vagus nerve was performed during esophagectomy. RLNP was observed in 229 (29.3%) of the patients after esophagectomy: 198 unilateral and 31 bilateral cases. Of the 198 unilateral RLNP, vocal cord paralysis was observed predominantly on the left side (82.7%). RLNP was significantly associated with postoperative respiratory complications (P < 0.001) requiring a tracheotomy (P < 0.001) and mechanical ventilation (P < 0.001) and was also associated with esophagogastric anastomotic leakage (P = 0.015); consequently, the postoperative hospital stay was longer for patients with RLNP (P < 0.001). A longer operation time (P < 0.001) and advanced age (P = 0.038) were identified as significant independent predictors of RLNP. Resection of the RLN together with metastatic nodes was performed in 29 cases. The patients underwent RLN reconstruction (n = 11) had a significantly shorter postoperative hospital stay than those without RLN reconstruction (n = 18) (P = 0.019). In conclusion, RLNP was related to a poorer postoperative course among patients undergoing an esophagectomy. New surgical technologies are recommended for prevention of RLNP.

show abstract

Section: Introductionmentioning

confidence: 99%

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Koyanagi

Igaki

Iwabu

et al. 2015

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…The distinction between "laryngeal framework surgery" and "thyroplasty", however, often remains unclear. Furthermore, there are inconsistencies in how the "Isshiki types" are defined and these seem to shift in time [12,15,16,21,23]. There have been a number of new developments which have added to the confusion regarding terminology and types which make it difficult to communicate between and to compare the results of different authors.…”

Section: Introductionmentioning

confidence: 99%

Laryngeal framework surgery: a proposal for classification and nomenclature by the Phonosurgery Committee of the European Laryngological Society

Friedrich¹,

Jong²,

Mahieu

et al. 2001

European Archives of Oto-Rhino-Laryngology

View full text Add to dashboard Cite

Laryngeal framework surgery, developed by Isshiki in the 1970s, is one of the most dynamic areas of phonosurgery and these procedures have served to considerably widen our spectrum and options for surgical improvement and/or changing of voice. As these techniques became more accepted and became common throughout the world, several new surgical modifications and different terms have been introduced. These new developments have lead to a confusion regarding terminology and types which make it difficult to communicate between and to compare the results of different authors. In an effort to create a more precise and descriptive list of definitions and terms, the Phonosurgery Committee of the European Laryngological Society has developed a new terminology for laryngeal framework surgery. In accordance with the concept of Isshiki, four types can be separated according to the intended purpose of the surgery: -Approximation laryngoplasty: medialization thyroplasty, arytenoid adduction. -Expansion laryngoplasty: lateralization thyroplasty, vocal fold abduction. -Relaxation laryngoplasty: shortening thyroplasty -Tensioning laryngoplasty: cricothyroid approximation, elongation thyroplasty. The proposed terms are functionally oriented and related closely to the intended purpose of the procedure or related to the underlying pathogenesis of the dysphonia. This new classification should provide a general framework suited not only to classify the current techniques but also to easily apply and adapt to include new procedures and future developments as necessary.

show abstract

“…La tiroplastia tipo I (descrita en sus inicios por Isshiki, 1974) (6,7) es una téc-nica que se ha ido perfeccionando. En sus inicios, la prótesis de silicona a colocar era tallada manualmente hasta obtener el tamaño adecuado, pero esto demandaba un mayor tiempo operatorio y formas de pró-tesis no siempre uniformes.…”

Section: An Fac Med 2008;69(1):52-5unclassified

Parálisis vocal permanente: corrección quirúrgica con tiroplastia tipo I

Yangali¹,

Moreno

2013

An Fac med

View full text Add to dashboard Cite

ResumenLa parálisis vocal permanente es causa de disfonía y episodios repetitivos de aspiración. Hacemos una revisión breve de la fisiopatología así como del procedimiento quirúrgico correctivo, conocido como tiroplastia. Palabras clave: Parálisis de las cuerdas vocales; tiroplastia. Abstract Permanent vocal cord paralysis causes dysphonia and repetetive aspiration episodes. We review vocal cord paralysis pathophysiology and the corrective surgical procedure known as thyroplasty. Key words: Vocal cord paralysis; thyroplasty. INTRODUCCIÓNLa parálisis de cuerda vocal se define como la falta de movilidad de una o las dos cuerdas vocales, lo cual es consecuencia de algún tipo de injuria sobre el nervio que inerva la musculatura intralaringea (nervio recurrente laringeo). Esta falta de movilidad de la cuerda vocal hace imposible la aproximación competente de ambas cuerdas vocales, generando como cuadro clínico una disfonía marcada acompañada de episodios aspirativos (1)(2)(3) . La parálisis vocal es una entidad mal tolerada por la persona que la padece. No solo la mala calidad de voz sino también los episodios de aspiración repetitivos, con sensación de ahogo que esta produce, generan frustración y limitaciones en las personas y más aún en aquellas que trabajan con la voz (profesores, locutores, recepcionistas), generando incluso problemas laborales o de integración social.La terapia de rehabilitación vocal, como elemento terapéutico en el manejo de esta entidad, es de vital importancia, básica-mente en los casos de etiología idiopática, vírica o inflamatoria, es decir, en los casos en los cuales puede haber una regresión por lo menos parcial de la parálisis vocal (3) . En los casos donde existe evidencia de lesión nerviosa permanente (nervio laríngeo recurrente, tronco vagal o a nivel central), si bien es cierto que la terapia de rehabilitación vocal continúa siendo de gran ayuda, los resultados no son del todo satisfactorios. Es en este contexto en que la tiroplastia cobra importancia.La tiroplastia, procedimiento quirúrgico que se realiza con anestesia local, busca corregir este defecto, con resultados por demás satisfactorios. Exponemos a continuación una breve revisión del tema de parálisis vocal, así como describimos la técnica quirúrgica de la tiroplastia tipo I. FISIOPATOLOGÍALa emisión de la voz es el resultado complejo y armonioso de una serie de funciones de diferentes órganos (pulmones, bronquios, tráquea, laringe, faringe, boca, senos paranasales, entre otros).El flujo de aire proveniente de los pulmones a través del árbol bronquial se encuentra con las cuerdas vocales a nivel de la caja laríngea. Este flujo de aire choca con las cuerdas vocales medializadas, provocando su vibración y generando sonido, el cual es modulado por la respiración, los movimientos de la lengua y la boca y encuentra su resonancia en los senos paranasales, emitiéndose un sonido armonioso y particular conocido como voz.En este complejo sistema, es muy importante la movilidad de las cuerdas vocales, que funcionan a manera de válvul...

show abstract

Recent Modifications in Thyroplasty Type I

Cited by 101 publications

References 8 publications

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Laryngeal framework surgery: a proposal for classification and nomenclature by the Phonosurgery Committee of the European Laryngological Society

Parálisis vocal permanente: corrección quirúrgica con tiroplastia tipo I

Contact Info

Product

Resources

About