Effects and Use of the Suture Direction Mimicking Only the Force Action of the Lateral Cricoarytenoid Muscle in Arytenoid Adduction Combined with Thyroplasty Type I

DOI Web Site 4 Citations 14 References
  • Sasai Hisanori
    Department of Otolaryngology-Head and Neck Surgery, Osaka General Medical Center
  • Watanabe Yusuke
    Department of Otolaryngology, MITA Hospital International University of Health and Welfare
  • Miyahara Hiroshi
    Department of Otolaryngology-Head and Neck Surgery, Osaka General Medical Center
  • Kubo Takeshi
    Department of Otolaryngology and Sensory Organ Surgery, Osaka University Graduate School of Medicine

Bibliographic Information

Other Title
  • 甲状軟骨形成術Ｉ型と披裂軟骨内転術の同時手術における筋突起の牽引方法について
  • コウジョウナンコツケイセイジュツ Iガタ ト ヒレツナンコツ ナイテンジュツ ノ ドウジ シュジュツ ニ オケル キン トッキ ノ ケンイン ホウホウ ニ ツイテ

Search this article

Abstract

Isshiki's arytenoid adduction combined with thyroplasty type I is a useful procedure for correcting the membranous vocal fold atrophy and the height difference between the two vocal folds, particularly in patients with a large posterior glottal chink and atrophy. Conventional arytenoid adduction (Isshiki's arytenoid adduction) is designed to place a suture through the muscular process of the arytenoid attached anteriorly to the thyroid ala, stimulating the function of the thyroarytenoid muscle and lateral cricoarytenoid muscle. Combining with thyroplasty type I, the suture direction of conventional arytenoid adduction prevented inserting implant material into the pocket of the thyroid cartilage window. In contrast to conventional arytenoid adduction, the suture direction in our approach is anchored anteroinferiorly, mimicking only the action of the lateral cricoarytenoid muscle (the major adductor of the larynx). It is used the thyroid cartilage window in thyroplasty type I to determine the direction of the lateral cricoarytenoid muscle. After approaching the muscular process based on Isshiki's arytenoid adduction, two nylon sutures are tied across the muscular process or the lateral cricoarytenoid muscle nearby the muscular process. The cricoarytenoid joint is not dislocated. One of the sutures was anchored to the inferior rear corner of the thyroid cartilage window to be used with thyroplasty type I and the other was anchored to the rear lower margin of the thyroid lamina. Gore-tex medialization thyroplasty is done after tying the sutures on the thyroid ala. Subjects were 30 unilateral paralytic dysphonia. Maximum phonation of all patients improved significantly after surgery. The preoperative and postoperative mean maximum phonation times were 6.0 and 17.9 seconds. No major complications occurred in this study. Our approach effectively combined arytenoid adduction and thyroplasty type I for patients with severe insufficient glottic closure.

Journal

Citations (4)*help

See more

References(14)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top