Article
Endoscopic arytenoid lateropexy for bilateral ankylotic vocal fold fixation
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Published: | April 17, 2009 |
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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.