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Erschienen in: European Archives of Oto-Rhino-Laryngology 1/2019

27.11.2018 | Laryngology

Glottic configuration changes and outcomes of endoscopic arytenoid abduction lateropexy

verfasst von: László Szakács, Balázs Sztanó, Vera Matievics, Zsófia Bere, Paul F. Castellanos, László Rovó

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 1/2019

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Abstract

Introduction

Endoscopic arytenoid abduction lateropexy (EAAL) is an effective glottis enlarging procedure for the treatment of bilateral vocal cord palsy (BVCP). The postoperative glottic configuration changes can be evaluated by modern, high-resolution, 3D image reconstructions. Functional results are described by spirometry as well as objective and subjective phoniatric tests.

Methods

Unilateral EAAL was performed in ten malignant thyroid gland tumor patients (eight women, two men), who had BVCP after thyroid surgery. Slicer 3D® software was used for morphometric analysis. Pre- and postoperative peak inspiratory flow (PIF) and standard phoniatric parameters were compared.

Results

The glottic gap improved significantly (+ 60%). Significant improvement of PIF was found in all cases. Phoniatric tests revealed better quality of voice and patient satisfaction. Their voices changed from a severely impaired to a socially acceptable, almost normal, quality.

Conclusion

The results support our clinical observations that the ideal position of the lateralization sutures is the one which provides a physiological abduction position of the arytenoid cartilage. Considering these good results, the surgical indications for minimally invasive endoscopic arytenoid lateropexy may be extended.
Literatur
1.
Zurück zum Zitat Rosenthal LH, Benninger MS, Deeb RH (2007) Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope 117(10):1864–1870 CrossRefPubMed Rosenthal LH, Benninger MS, Deeb RH (2007) Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope 117(10):1864–1870 CrossRefPubMed
2.
Zurück zum Zitat Gould WJ, Sataloff RT, Spiegel JR (1993) Voice surgery. Mosby-Year Book, St. Louis Gould WJ, Sataloff RT, Spiegel JR (1993) Voice surgery. Mosby-Year Book, St. Louis
3.
Zurück zum Zitat Sapundzhiev N, Lichtenberger G, Eckel HE et al (2008) Surgery of adult bilateral vocal fold paralysis in adduction: history and trends. Eur Arch Otorhinolaryngol 265(12):1501–1514 CrossRefPubMed Sapundzhiev N, Lichtenberger G, Eckel HE et al (2008) Surgery of adult bilateral vocal fold paralysis in adduction: history and trends. Eur Arch Otorhinolaryngol 265(12):1501–1514 CrossRefPubMed
4.
Zurück zum Zitat Tucker H (1987) The larynx. Thieme Medical Publishers, New York Tucker H (1987) The larynx. Thieme Medical Publishers, New York
5.
Zurück zum Zitat Marie JP, Dehesdin D, Ducastelle T, Senant J (1989) Selective reinnervation of the abductor and adductor muscles of the canine larynx after recurrent nerve paralysis. Ann Otol Rhinol Laryngol 98(7 Pt 1):530–536 CrossRefPubMed Marie JP, Dehesdin D, Ducastelle T, Senant J (1989) Selective reinnervation of the abductor and adductor muscles of the canine larynx after recurrent nerve paralysis. Ann Otol Rhinol Laryngol 98(7 Pt 1):530–536 CrossRefPubMed
6.
Zurück zum Zitat Marina MB, Marie JP, Birchall MA (2011 Dec) Laryngeal reinnervation for bilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg 19(6):434–438 CrossRefPubMed Marina MB, Marie JP, Birchall MA (2011 Dec) Laryngeal reinnervation for bilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg 19(6):434–438 CrossRefPubMed
7.
Zurück zum Zitat Zealear DL, Rainey CL, Herzon GD, Netterville JL (1996) Ossoff RH Electrical pacing of the paralyzed human larynx. Ann Otol Rhinol Laryngol 105(9):689–693 CrossRefPubMed Zealear DL, Rainey CL, Herzon GD, Netterville JL (1996) Ossoff RH Electrical pacing of the paralyzed human larynx. Ann Otol Rhinol Laryngol 105(9):689–693 CrossRefPubMed
8.
Zurück zum Zitat Mueller AH (2011) Laryngeal pacing for bilateral vocal fold immobility. Curr Opin Otolaryngol Head Neck Surg 19(6):439–443 CrossRefPubMed Mueller AH (2011) Laryngeal pacing for bilateral vocal fold immobility. Curr Opin Otolaryngol Head Neck Surg 19(6):439–443 CrossRefPubMed
9.
Zurück zum Zitat Sellars I, Sellars S (1983) Cricoarytenoid joint structure and function. J Laryngol Otol 97:1027–1034 CrossRefPubMed Sellars I, Sellars S (1983) Cricoarytenoid joint structure and function. J Laryngol Otol 97:1027–1034 CrossRefPubMed
10.
Zurück zum Zitat Sztanó B, Szakács L, Madani S, Tóth F, Bere Z, Castellanos PF, Rovó L (2014) Comparison of endoscopic techniques designed for posterior glottic stenosis—a cadaver morphometric study. Laryngoscope 124:705–710 CrossRefPubMed Sztanó B, Szakács L, Madani S, Tóth F, Bere Z, Castellanos PF, Rovó L (2014) Comparison of endoscopic techniques designed for posterior glottic stenosis—a cadaver morphometric study. Laryngoscope 124:705–710 CrossRefPubMed
11.
Zurück zum Zitat Szakács L, Sztanó B, Matievics V, Bere Z, Bach A, Castellanos PF, Rovó L (2015) A comparison between transoral glottis-widening techniques for bilateral vocal fold immobility. Laryngoscope 125(11):2522–2529 CrossRefPubMed Szakács L, Sztanó B, Matievics V, Bere Z, Bach A, Castellanos PF, Rovó L (2015) A comparison between transoral glottis-widening techniques for bilateral vocal fold immobility. Laryngoscope 125(11):2522–2529 CrossRefPubMed
12.
Zurück zum Zitat Vining DJ1, Liu K, Choplin RH, Haponik EF (1996) Virtual bronchoscopy. Relationships of virtual reality endobronchial simulations to actual bronchoscopic findings. Chest 109(2):549–553 CrossRefPubMed Vining DJ1, Liu K, Choplin RH, Haponik EF (1996) Virtual bronchoscopy. Relationships of virtual reality endobronchial simulations to actual bronchoscopic findings. Chest 109(2):549–553 CrossRefPubMed
13.
Zurück zum Zitat Rabe KF, Hurd S, Anzueto A et al (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 176:532–555 CrossRefPubMed Rabe KF, Hurd S, Anzueto A et al (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 176:532–555 CrossRefPubMed
14.
Zurück zum Zitat Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G,. Benninger MS, Newman CW (1997) The voice handicap index (VHI) development and validation. Am J Speech Lang Pathol 6:66–70 CrossRef Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G,. Benninger MS, Newman CW (1997) The voice handicap index (VHI) development and validation. Am J Speech Lang Pathol 6:66–70 CrossRef
15.
Zurück zum Zitat Liang BM, Lam DCL, Feng YL (2012) Clinical applications of lung function tests: a revisit. Respirology 17:611–619 CrossRefPubMed Liang BM, Lam DCL, Feng YL (2012) Clinical applications of lung function tests: a revisit. Respirology 17:611–619 CrossRefPubMed
16.
Zurück zum Zitat Rovó L, Venczel K, Torkos A, Majoros V, Sztanó B, Jóri J (2008) Endoscopic arytenoid lateropexy for isolated posterior glottic stenosis, Laryngoscope 118(9):1550–1555 CrossRefPubMed Rovó L, Venczel K, Torkos A, Majoros V, Sztanó B, Jóri J (2008) Endoscopic arytenoid lateropexy for isolated posterior glottic stenosis, Laryngoscope 118(9):1550–1555 CrossRefPubMed
17.
Zurück zum Zitat Rovó L, Madani S, Sztanó B, Majoros V, Smehák G, Szakács L, Jóri J (2010) A new thread guide instrument for endoscopic lateropexy. Laryngoscope 120(10):2002–20077 CrossRefPubMed Rovó L, Madani S, Sztanó B, Majoros V, Smehák G, Szakács L, Jóri J (2010) A new thread guide instrument for endoscopic lateropexy. Laryngoscope 120(10):2002–20077 CrossRefPubMed
19.
Zurück zum Zitat Burke AJ, Vining DJ, McGuirt WF Jr, Postma G, Browne JD (2000) Evaluation of airway obstruction using virtual endoscopy. Laryngoscope 110(1):23–29 CrossRefPubMed Burke AJ, Vining DJ, McGuirt WF Jr, Postma G, Browne JD (2000) Evaluation of airway obstruction using virtual endoscopy. Laryngoscope 110(1):23–29 CrossRefPubMed
20.
Zurück zum Zitat Yunus M (2012) Helical CT scan with 2D and 3D reconstructions and virtual endoscopy versus conventional endoscopy in the assessment of airway disease in neonates, infants and children. J Pak Med Assoc 62(11):1154–1160 PubMed Yunus M (2012) Helical CT scan with 2D and 3D reconstructions and virtual endoscopy versus conventional endoscopy in the assessment of airway disease in neonates, infants and children. J Pak Med Assoc 62(11):1154–1160 PubMed
21.
Zurück zum Zitat Gallivan RP1, Nguyen TH, Armstrong WB (1999) Head and neck computed tomography virtual endoscopy: evaluation of a new imaging technique. Laryngoscope 109(10):1570–1579 CrossRefPubMed Gallivan RP1, Nguyen TH, Armstrong WB (1999) Head and neck computed tomography virtual endoscopy: evaluation of a new imaging technique. Laryngoscope 109(10):1570–1579 CrossRefPubMed
22.
Zurück zum Zitat König AH, Gröller E (2001) 3D medical visualization: breaking the limits of diagnostics and treatment. ERCIM News 44:27–8 König AH, Gröller E (2001) 3D medical visualization: breaking the limits of diagnostics and treatment. ERCIM News 44:27–8
23.
Zurück zum Zitat Nain D (2002) an interactive virtual endoscopy tool with automatic path generation. Master’s thesis, MIT AI Lab Nain D (2002) an interactive virtual endoscopy tool with automatic path generation. Master’s thesis, MIT AI Lab
24.
Zurück zum Zitat Silverman PM, Zeiberg AS, Sessions RB, Troost TR, Zeman RK (1995) Three-dimensional imaging of the hypopharynx and larynx by means of helical (spiral) computed tomography. Comparison of radiological and otolaryngological evaluation. Ann Otol Rhinol Laryngol 104(6):425–431 CrossRefPubMed Silverman PM, Zeiberg AS, Sessions RB, Troost TR, Zeman RK (1995) Three-dimensional imaging of the hypopharynx and larynx by means of helical (spiral) computed tomography. Comparison of radiological and otolaryngological evaluation. Ann Otol Rhinol Laryngol 104(6):425–431 CrossRefPubMed
25.
Zurück zum Zitat Toyota K, Uchida H, Ozasa H, Motooka A, Sakura S, Saito Y (2004) Preoperative airway evaluation using multi-slice three-dimensional computed tomography for a patient with severe tracheal stenosis. Br J Anaesth 93(6):865–867 CrossRefPubMed Toyota K, Uchida H, Ozasa H, Motooka A, Sakura S, Saito Y (2004) Preoperative airway evaluation using multi-slice three-dimensional computed tomography for a patient with severe tracheal stenosis. Br J Anaesth 93(6):865–867 CrossRefPubMed
26.
Zurück zum Zitat Triglia JM, Nazarian B, Sudre-Levillain I, Marciano S, Moulin G, Giovanni A (2002) Virtual laryngotracheal endoscopy based on geometric surface modeling using spiral computed tomography data. Ann Otol Rhinol Laryngol 111(1):36–43 CrossRefPubMed Triglia JM, Nazarian B, Sudre-Levillain I, Marciano S, Moulin G, Giovanni A (2002) Virtual laryngotracheal endoscopy based on geometric surface modeling using spiral computed tomography data. Ann Otol Rhinol Laryngol 111(1):36–43 CrossRefPubMed
27.
Zurück zum Zitat Loth A, Corny J, Santini L, Dahan L, Dessi P, Adalian P, Fakhry N (2015) Analysis of hyoid-larynx complex using 3D geometric morphometrics. Dysphagia 30(3):357–364 CrossRefPubMed Loth A, Corny J, Santini L, Dahan L, Dessi P, Adalian P, Fakhry N (2015) Analysis of hyoid-larynx complex using 3D geometric morphometrics. Dysphagia 30(3):357–364 CrossRefPubMed
28.
Zurück zum Zitat Bakhshaee H, Moro C, Kost K, Mongeau L (2013) Three-dimensional reconstruction of human vocal folds and standard laryngeal cartilages using computed tomography scan data. J Voice 27(6):769–777 CrossRefPubMed Bakhshaee H, Moro C, Kost K, Mongeau L (2013) Three-dimensional reconstruction of human vocal folds and standard laryngeal cartilages using computed tomography scan data. J Voice 27(6):769–777 CrossRefPubMed
29.
Zurück zum Zitat Hiramatsu H, Tokashiki R, Suzuki M (2008) Usefulness of three-dimensional computed tomography of the larynx for evaluation of unilateral vocal fold paralysis before and after treatment: technique and clinical applications. Eur Arch Otorhinolaryngol 265(6):725–730 CrossRefPubMed Hiramatsu H, Tokashiki R, Suzuki M (2008) Usefulness of three-dimensional computed tomography of the larynx for evaluation of unilateral vocal fold paralysis before and after treatment: technique and clinical applications. Eur Arch Otorhinolaryngol 265(6):725–730 CrossRefPubMed
30.
Zurück zum Zitat Jóri J, Rovó L, Czigner J (1998) Vocal cord laterofixation as early treatment for acute bilateral abductor paralysis after thyroid surgery. Eur Arch Otorhinolaryngol 255:375–378 CrossRefPubMed Jóri J, Rovó L, Czigner J (1998) Vocal cord laterofixation as early treatment for acute bilateral abductor paralysis after thyroid surgery. Eur Arch Otorhinolaryngol 255:375–378 CrossRefPubMed
31.
Zurück zum Zitat Dennis DP, Kashima H (1989) Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 98:930–934 CrossRefPubMed Dennis DP, Kashima H (1989) Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 98:930–934 CrossRefPubMed
32.
Zurück zum Zitat Kashima HK (1984) Documentation of upper airway obstruction in unilateral vocal cord paralysis: flow-volume loop studies in 43 subjects. Laryngoscope 94:923–937 CrossRefPubMed Kashima HK (1984) Documentation of upper airway obstruction in unilateral vocal cord paralysis: flow-volume loop studies in 43 subjects. Laryngoscope 94:923–937 CrossRefPubMed
33.
Zurück zum Zitat Cantarella G, Fasano V, Bucchioni E, Domenichini E, Cesana BM (2003) Spirometric and plethysmographic assessment of upper airway obstruction in laryngeal hemiplegia. Ann Otol Rhinol Laryngol 112(12):1014–1020 CrossRefPubMed Cantarella G, Fasano V, Bucchioni E, Domenichini E, Cesana BM (2003) Spirometric and plethysmographic assessment of upper airway obstruction in laryngeal hemiplegia. Ann Otol Rhinol Laryngol 112(12):1014–1020 CrossRefPubMed
34.
Zurück zum Zitat Dursun G, Gokcan MK (2006) Aerodynamic, acoustic and functional results of posterior transverse laser cordotomy for bilateral abductor vocal fold paralysis. J Laryngol Otol 120(4):282–288 CrossRefPubMed Dursun G, Gokcan MK (2006) Aerodynamic, acoustic and functional results of posterior transverse laser cordotomy for bilateral abductor vocal fold paralysis. J Laryngol Otol 120(4):282–288 CrossRefPubMed
35.
Zurück zum Zitat Vössing M, Wassermann K, Eckel HE, Ebeling O (1995) Peak flow measurement in patients with laryngeal and tracheal stenoses. A simple and valuable spirometric method. HNO 43(2):70–75 PubMed Vössing M, Wassermann K, Eckel HE, Ebeling O (1995) Peak flow measurement in patients with laryngeal and tracheal stenoses. A simple and valuable spirometric method. HNO 43(2):70–75 PubMed
36.
37.
Zurück zum Zitat Werner JA, Lippert BM (2002) Laterofixation der Stimmlippe stat Tracheotomie bei akuter beidseitiger Stimmlippenparese. Dtsch Med Wochenschr 127:917–922 CrossRefPubMed Werner JA, Lippert BM (2002) Laterofixation der Stimmlippe stat Tracheotomie bei akuter beidseitiger Stimmlippenparese. Dtsch Med Wochenschr 127:917–922 CrossRefPubMed
38.
Zurück zum Zitat Harnisch W, Brosch S, Schmidt M, Hagen R (2008) Breathing and voice quality after surgical treatment for bilateral vocal cord paralysis. Arch Otolaryngol Head Neck Surg 134(3):278–284 CrossRefPubMed Harnisch W, Brosch S, Schmidt M, Hagen R (2008) Breathing and voice quality after surgical treatment for bilateral vocal cord paralysis. Arch Otolaryngol Head Neck Surg 134(3):278–284 CrossRefPubMed
Metadaten
Titel
Glottic configuration changes and outcomes of endoscopic arytenoid abduction lateropexy
verfasst von
László Szakács
Balázs Sztanó
Vera Matievics
Zsófia Bere
Paul F. Castellanos
László Rovó
Publikationsdatum
27.11.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 1/2019
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5215-x

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