Objective: Vocal fold paralysis in adduction can result in dyspnea. The authors have previously described an original vocal fold lateralization technique performed exclusively through an endoscopic approach. In this work, we studied long and short-term results of this procedure on dyspnea, phonation, and swallowing.
Study Design: Retrospective cohort study through data from medical records and operative notes. Patients with unilateral or bilateral vocal fold paralysis in adduction who underwent transoral lateralization were included.
Methods: In all patients, under laryngosuspension, a supraglottic laryngotomy was performed with CO laser and a lateralization suture was passed through the thyroid cartilage to the vocal process of the vocal fold with the desired tension allowing lateralization of the arytenoid and corresponding vocal fold. We studied evolution of breathing, phonation, and swallowing in all patients who underwent lateralization suture. We tried to correlate symptoms to preoperative and postoperative glottic area, inter-arytenoid distance, and anterior glottic angle.
Results: Eighteen patients were included in the study. Three patients were tracheostomy-dependent and were successfully decannulated. All other cases presented short and long-term significant improvement of their dyspnea index score (P < 0.001) in correlation with glottic area enlargement (P < 0.001). There was no statistical difference between preoperative and postoperative voice and swallowing parameters.
Conclusion: Our transoral lateralization technique allows enlargement of the glottic aperture in case of laryngeal dyspnea secondary to vocal fold paralysis in adduction. This technique optimally preserves laryngeal structures, especially the mucosa. It is reproducible and reliable for all laryngologists experienced in reconstructive transoral laser microsurgery.
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http://dx.doi.org/10.1016/j.jvoice.2019.11.009 | DOI Listing |
J Voice
December 2024
Department of Duquesne-China Health Institute, John G. Rangos Sr. School of Health Sciences, Duquesne University, Pittsburgh, PA; Speech Science Laboratory, Faculty of Education, The University of Hong Kong, Hong Kong SAR, China.
J Voice
December 2024
Indiana University School of Medicine (IUSM), Indianapolis, Indiana; IUSM Department of Otolaryngology-Head and Neck Surgery, Indianapolis, Indiana; Purdue University Department of Speech, Language, and Hearing Sciences, West Lafayette, Indiana. Electronic address:
Objectives/hypothesis: Given the complex pathology underlying unilateral vocal fold paralysis (UVFP), there has been limited systematic exploration of curative treatments in humans. Central to the investigation of experimental therapies includes establishing a reliable and analogous large animal model. The study goal was to create a standardized porcine model of UVFP by establishing characteristic pathophysiology and functional outcomes.
View Article and Find Full Text PDFFront Cell Dev Biol
December 2024
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Approaches to regenerate vocal fold in glottic insufficiency remains to be a focus for exploration. This is attributed to the applications of cells or biological molecules alone result in fast degradation and inadequate for regeneration. Development of an injectable hydrogel for glottic insufficiency is challenging, as it needs to be non-cytotoxic, elastic yet possess good strength and easy to fabricate.
View Article and Find Full Text PDFAm J Otolaryngol
November 2024
Surgery, Division of Otolaryngology, University of New Mexico Hospital, Albuquerque, NM, USA. Electronic address:
Introduction: There is a paucity of literature on pre-adolescent paradoxical vocal fold motion (PVFM), PVFM is a sub-type of inducible laryngeal obstruction. Studies typically focus on older patients, however the discovery of this entity in pre-adolescent pediatric patients has led to more questions about how this entity manifests differently and is treated differently in younger populations. Initially considered psychosomatic and commonly mistaken for asthma, PVFM etiology is now thought to be associated underlying neurologic conditions and may have irritant triggers with proposed mechanisms related to laryngeal hypersensitivity.
View Article and Find Full Text PDFBMC Emerg Med
December 2024
Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539, Zhongxiao Road, East District, Chiayi City, 600, Taiwan.
Background: In emergency settings, difficult intubations often occur unexpectedly despite pre-intubation assessments. Traditional glottic view scoring systems for direct laryngoscope may not apply to video laryngoscopy. With video laryngoscopy, the vertical location of the glottis on the monitor can be clearly defined.
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