Suturing silastic sheet from outside into larynx cavity: measurement of angles and clinical practice

Zhang, Na; Shi, Fang; Tan, Deyan; Huang, Wei; Chen, Xiaoping; Wu, Haitao

doi:10.3109/00016489.2013.779022

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…5 One study found that 25% of larynges (5 of 20) could not be exposed with a large laryngoscope, thus precluding the use of the Lichtenberger endo-extralaryngeal suture passer in these patients. 3 Thus, there are circumstances in which an alternate technique must be employed for keel placement. The use of percutaneously placed devices for passing sutures from the external neck to within the larynx has been previously described.…”

Section: Discussionmentioning

confidence: 99%

“…The use of percutaneously placed devices for passing sutures from the external neck to within the larynx has been previously described. 2,3 Matrka and Simpson 2 depicted the use of angiocatheters and Zhang et al 3 described employing hollow-bore needles for this purpose. Although these methods avoid the need for the Lichtenberger needle passer, they can be technically challenging, as they require threading a suture through a small aperture using endoscopic instruments.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic Suture Retriever for Endolaryngeal Keel Placement in Treatment of Anterior Glottic Webs

Beswick

Bergeron

Sung

2014

Ann Otol Rhinol Laryngol

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Endoscopic keel placement is a widely used procedure for treating anterior glottic webs and requires suture passage from within the larynx to the anterior neck to secure the keel into position. This is the first report of an exo-endolaryngeal suture retriever for placement of a laryngeal keel. This technique provides a safe, reliable, and efficient alternative to endo-extralaryngeal needle puncture and uses materials that are available in many operating room settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Suture Retriever for Endolaryngeal Keel Placement in Treatment of Anterior Glottic Webs

Beswick

Bergeron

Sung

2014

Ann Otol Rhinol Laryngol

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“…Occasional difficulties in microscopic laryngeal exposure and needle carrier unavailability are main abstacles. 2,4,5…”

Section: Discussionmentioning

confidence: 99%

“…Liyanage et al 4 described a lateral‐to‐lateral transfixation technique through the cricothyroid membrane but unfortunately with improper keel placement. Zhang et al 5 described inferior and superior punctures through the cricothyroid and thyrohyoid membranes, respectively. Through these needles, they struggled to manipulate the Prolene thread—first from outside‐inside through an inferior puncture, then from inside‐out through a superior puncture.…”

Section: Discussionmentioning

confidence: 99%

Simple Endoscopic Application of Laryngeal Keel Stent

Sweed¹,

Mobashir²,

Mohamed³

et al. 2021

Otolaryngol.--head neck surg.

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This study describes a simple extraendolaryngeal technique to apply laryngeal keel in dealing with anterior commissure web/fibrosis. Standard extraendolaryngeal punctures were applied via 20-gauge needles, 30° from the skin surface, in midline through the cricothyroid and thyrohyoid membranes. These needles were used as a conduit for the passage of 2/0 Prolene threads, which were retrieved through the laryngoscope by crocodile forceps. Both laryngoscopic ends of the Prolene threads were passed through a fabricated silastic sheet (keel stent) via a 22-gauge free needle, and these ends were tied to have a secure internal knot. Steady traction was applied on the other 2 external threads until there was appropriate application of this keel stent within the vicinity of anterior commissure. Finally, these external ends were tied to have a secure external knot. A keel stent could be applied without the need for special instrumentation and with reasonable outcomes (proper healing of anterior commissure, satisfied voice outcome, and patent airway).

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“…Zhang et al . [7] published a study of 14 cadavers and twenty patients to determine reasonable extra-endolaryngeal puncturing sites and angles for implantation of laryngeal silastic sheet.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia management for a case of laryngeal keel placement

et al. 2017

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Congenital laryngeal web is a rare anomaly with incidence of 1 in 10,000 births. Its clinical presentation may range from an asymptomatic patient or mild hoarseness of voice to severe respiratory stridor. The primary goals of surgical intervention for congenital laryngeal web are to establish a patent airway and to achieve a good voice quality. As recurrence rate after plain excision of laryngeal web is very high, its removal may be coupled by placement of a silastic keel in between vocal cords. Endolaryngeal placement of a keel is definitely less invasive than laryngofissure, but little is known about its anesthesia management. Frequent ventilatory adjustment and endotracheal tube (ETT) manipulations are needed along with vigilant monitoring. Risk of perforation or accidental dislodgment of the ETT and laryngeal edema are other concerns in management. We report a case.

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Suturing silastic sheet from outside into larynx cavity: measurement of angles and clinical practice

Cited by 6 publications

References 19 publications

Endoscopic Suture Retriever for Endolaryngeal Keel Placement in Treatment of Anterior Glottic Webs

Endoscopic Suture Retriever for Endolaryngeal Keel Placement in Treatment of Anterior Glottic Webs

Simple Endoscopic Application of Laryngeal Keel Stent

Anesthesia management for a case of laryngeal keel placement

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