Reversible immediate and definitive lateralization of paralyzed vocal cords

Lichtenberger, György

doi:10.1007/s004050050176

Cited by 47 publications

(30 citation statements)

References 18 publications

(19 reference statements)

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“…The majority of our patients (66.7%) had had tracheotomy performed previously. An excellent alternative for tracheotomy seems to be the technique of laterofixation after Lichtenberger et al [10,20]. The technique is simple, fast, and inexpensive and most importantly of all -reversible.…”

Section: Discussionmentioning

confidence: 99%

Możliwości naprawcze porażeń fałdów głosowych w wyniku operacji gruczołu tarczowego

Lisowska

Sowa

Misiołek

et al. 2015

Endokrynologia Polska

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Introduction: Surgery of the thyroid gland remains the main cause of bilateral vocal cord palsy (VCP). Ventilation problem is the main problem in such situations. There are a couple of corrective surgical procedures in the case of VCP. The aim of our study was to show the possibility of widening of the glottis, and to evaluate the techniques and effects of surgical treatments due to bilateral VCP resulting from thyroid gland surgery. Material and methods: Five methods of surgical treatment were used: laser-assisted posterior cordectomy, according to Denis and Kashima; laser-assisted bilateral medial arytenoidectomy, as proposed by Crumley; laser-assisted posterior ventriculocordectomy, as described by Pia; laser-assisted total arytenoidectomy with posterior cordectomy, as presented by Ossoff; and laterofixation, according to Lichtenberger. The postoperative patient's subjective improvement was assessed using visual analogue scale. Results: Between 1998 and 2014 we operated on 270 patients with bilateral VCP. Paresis occurred as the result of the iatrogenic effect of thyroid gland surgery in 255 patients (94.4%) vs. 15 (7.6%) from other causes. The majority of our patients (77.6%) had undergone laser arytenoidectomy with posterior partial cordectomy, and in 13.7% of them Lichtenberger laterofixation had been performed. Ossoff 's surgery gives good ventilation results: successful decannulation (62.9% after first surgery; 97.6% final rate) and significant subjective ventilation improvement in 96% of patients.

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Section: Discussionmentioning

confidence: 99%

Możliwości naprawcze porażeń fałdów głosowych w wyniku operacji gruczołu tarczowego

Lisowska

Sowa

Misiołek

et al. 2015

Endokrynologia Polska

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“…Insertion of both needles may be performed in patients sitting on an ENT office chair, having a transnasal laryngoscopy visualization during sling arytenoid adduction and augmentation procedures performed within the same treatment session. Another application of the wire loop needle threader can be to lateralize a vocal fold from an external approach when a sling is created around the vocal fold (or vocal process) and pulled laterally as proposed by Lichtenberger [10] with his endo-extralaryngeal lateralization procedure. The advantage might be that this slinging procedure with a wire loop needle threader may be performed without having the patient brought to the operating room for suspension microlaryngoscopy in general anesthesia.…”

Section: Future Aspectsmentioning

confidence: 99%

Sling arytenoid adduction

Heß

Schroeder

Püschel

2011

Eur Arch Otorhinolaryngol

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The purpose of this study was to describe a simplified arytenoid rotation technique and to test its applicability in excised human larynges. A non-absorbable monofilament thread is slung around the muscular process of the arytenoid cartilage through an external approach. During visual control through flexible endoscopy, two needles and a wire loop needle threader are the only instruments needed. Thread tensioning and fixation results in a stabilized arytenoid adduction. This technique avoids cricothyroid joint disarticulation and leaves the thyroid cartilage intact. The practicability of the technique was proven in five excised larynx experiments. In two clinical cases, the muscular process was slung and pulled with a monofilament thread. Tension in the vector direction parallel to the LCA muscle showed an effective and stable arytenoid rotation with complete closure of the posterior glottis. The rotational effect following sling arytenoid adduction (SAA) is similar to conventional arytenoid adduction surgery outcome. However, SAA is performed from an external approach and avoids dissection of cartilage. Challenging dissections to reach the muscular process are avoided. In some cases of unilateral vocal fold immobility, arytenoid rotation may be performed by using the SAA technique, which allows for an external and extralaryngeal approach. Further studies should assess the clinical value of this technique. In principal, the wire loop needle threader can also be employed for external vocal fold lateralization procedures.

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“…Initially, these operations were done via an anaesthesia method involving gamma hidroxybutirate and diazepam without intubation, allowing patients to have the surgery done without tracheostomy [4]. In recent times, the glottis-dilation operation is performed with high frequency JET ventilation, especially for those undergoing reversible glottis dilation [9]. In the past decade, endo-extralaryngeal glottis-dilating operations have become popular in both Europe and the United States [2,5,6,8].…”

Section: Introductionmentioning

confidence: 99%

“…These methods, based on endo-extralaryngeal suture techniques, have been introduced in many institutions in the clinical practice of laryngology. During this period of time, both reversible and irreversible glottis-dilation operations have been developed and presented [2,3,4,5,6,7,8,9]. Initially, these operations were done via an anaesthesia method involving gamma hidroxybutirate and diazepam without intubation, allowing patients to have the surgery done without tracheostomy [4].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the results of glottis-dilating operations using lung function tests

Leitersdorfer¹,

Lichtenberger²,

Kovács³

2002

Eur Arch Otorhinolaryngol

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Our aim was to obtain an objective evaluation of the airway before and after glottis-dilating operations utilizing lung function tests. The charts of 109 patients who underwent either reversible or irreversible glottis-dilating operations by Lichtenberger were reviewed. 64 nonselected cases of these patients, all with irreversible glottis-dilating operations, were studied. Lung function tests that were performed were body-pletysmography, forced inspiratory volume (FIV1), forced expiratory volume (FEV1), peak inspiratory flow rate (PIF), peak expiratory flow rate (PEF) and resistance of the airways (RAW). The FEV1, FIV1, PEF and PIF all improved following irreversible glottis-dilating operations. The RAW was remarkably decreased post-operatively as compared to pre-operatively. In conclusion, the airways of patients undergoing irreversible glottis-dilation operations improved moderately to well following such surgeries. Lung function tests are an objective means of evaluating the airway before and after surgery.

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Reversible immediate and definitive lateralization of paralyzed vocal cords

Cited by 47 publications

References 18 publications

Możliwości naprawcze porażeń fałdów głosowych w wyniku operacji gruczołu tarczowego

Możliwości naprawcze porażeń fałdów głosowych w wyniku operacji gruczołu tarczowego

Sling arytenoid adduction

Assessment of the results of glottis-dilating operations using lung function tests

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