gms | German Medical Science

Posterior glottic stenosis (PGS) may cause more or less severe dyspnoe. One of the treatment options is the endoscopic suture lateralization of the fixed vocal folds after proper mobilization. Considering our clinical experiences the arytenoid lateropexy provide the best results (The vocal folds are fixed by the suture into their physiologic, most abducted position). To confirm these clinical observations morphometric study was performed in 60 cadaver larynges (32 male, 28 female) to find the ideal position for the lateralizing suture loop.

Four different suture glottis widening operations were analyzed and the most important parameters of the posterior commissure were assessed by digital image analyzer program.

The classic, endoscopic laterofixation of the vocal fold (a single suture loop was inserted into the posterior third of the vocal fold) provided 5.14mm mean distance between the vocal process of the lateralized vocal fold and the midline and 30.46o angle in the posterior commissure between vocal process – posterior commissure line and midline.

After arytenoid lateropexy 7.22 mm and 50.26o were measured.

Our morphometric study proved that arytenoid lateropexy provided more space in the posterior glottic area than simple laterofixation of the vocal fold. Considering these good results the surgical indications of minimally invasive endoscopic arytenoid lateropexy may be extended. For our new technique special instruments were designed.