gms | German Medical Science

The minimally invasive endoscopic arytenoid lateropexy (EAL) is proved to be a really effective suture vocal cord lateralizing technique for the treatment of bilateral vocal cord impairment (BVCI). The arytenoid cartilage is directly lateralized to normal abducted position by sutures. This procedure provide immediately large glottic gap, stable, long-lasting results. A new endoscopic thread guide instrument (ETGI) have been introduced to facilitate this method with rapid and safe creation of fixating loops at the proper position.

In the past years 237 adult BVCI patients were operated with this procedure. Excellent clinical results could be observed that encourged us to extend the surgical indications of EAL: four children were operated too (Age: 2 weeks – 16 years). The main causes of pediatric glottic stenoses are congenital malformations and the complications of long-term intubation. Considering the pediatric laryngeal anatomy smaller ETGI-s were designed. All patients could be extubated after surgery. Subjective ‘Quality of Life’ questionnaire, spirometric tests (if possible) and endoscopic examinations were applied to evaluate the results.

Based on our first experiences EAL seemed to be a simple effective solution for pediatric BVCI patients.