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80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

Endoscopic arytenoid lateropexy for bilateral ankylotic vocal fold fixation

Meeting Abstract

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno039

doi: 10.3205/09hno039, urn:nbn:de:0183-09hno0399

Published: July 22, 2009

© 2009 Rovó et al.
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Outline

Text

Objectives: Mechanical fixation of the vocal folds, most frequently develops after long-term intubation, but other pathological degenerative processess may also limit the abduction of the arytenoid cartilages. Endoscopic arytenoid lateropexy combined with other mobilization techniques may be a minimally invasive solution.

Study design: 38 consecutive patients with this ankylotic problem underwent surgery. Endoscopically, the immobile arytenoids were released by a combination of CO2 laser and a right-angled endolaryngeal scythe designed for this purpose. For the lateropexy of the arytenoids a new endolaryngeal thread guide instrument was introduced.

Results: 32 patients achieved an excellent breathing ability, only effort dyspnea remained in 5 cases. One patient could not be decannulated due to aspiration. In 29 cases, phonation significiantly improved after the removal of the fixing sutures.

Conclusion: After proper mobilization, endoscopic arytenoid lateropexy can be considered as a minimally invasive function-preserving procedure even for severe ankylotic stenoses. This treatment option provides stable improvements in breathing ability and good voice quality without the need for tracheostomy.