ARYTENOID ADDUCTION TECHNIQUE, RESULTS AND ITS RELATION TO MEDIALIZATION THYROPLASTY
Mohamed Ibrahim Seddick;
Abstract
L
aryngeal framework surgery offers a safe and usually effective method to improve incomplete glottis closure and adjust vocal fold tension.
Selection of phonosurgical procedures in cases of paralytic dysphonia depends on the severity of patient's symptoms, glottic configuration, the tone of the paralysed cord and status of paralysis (Temporary or Permanent). Since arytenoid adduction (AA) is an irreversible and complicated procedure compared to Medialization (M. L) it is adapted only in long standing, uncompensated, unilateral vocal cord paralysis with breathy dysphonia and also in cases where it is ascertained that the neuronal function of the affected vocal cord will not return to normal.
Dysphonia due to unilateral vocal fold immobility (UVFI) can have detrimental effects on quality of patient daily lives. Arytenoid adduction and type I thyroplasty are widely accepted treatment methods for UVFI. However, postoperative voice does not always reach normal although dysphonia is improved to a certain degree
The goal of a corrective procedure is to move the edge of the paralyzed vocal fold closer to the midline, to facilitate glottal closure during phonation.
The ideal surgical procedure for correction of glottal incompetence would improve both sphincteric function and sound production while preserving the glottal airway.
Arytenoid adduction (AA) is used in the treatment of glottal insufficiency. Unlike medialization laryngoplasty, AA acts through direct traction on the arytenoid cartilage at the muscular process mimicking the action of the lateral cricoarytenoid muscle. AA is an important adjunct in selected cases of vocal fold paralysis.
In patients with vocal fold paralysis who have a lack of vocal process contact during phonation (large posterior gap), shortened immobile vocal fold and those with vocal folds at different levels, AA should be considered in addition to ML. Videostroboscopy often provides valuable information about vocal process contact, vocal fold height, length and therefore is useful preoperatively in assessing whether a patient may need an AA.
aryngeal framework surgery offers a safe and usually effective method to improve incomplete glottis closure and adjust vocal fold tension.
Selection of phonosurgical procedures in cases of paralytic dysphonia depends on the severity of patient's symptoms, glottic configuration, the tone of the paralysed cord and status of paralysis (Temporary or Permanent). Since arytenoid adduction (AA) is an irreversible and complicated procedure compared to Medialization (M. L) it is adapted only in long standing, uncompensated, unilateral vocal cord paralysis with breathy dysphonia and also in cases where it is ascertained that the neuronal function of the affected vocal cord will not return to normal.
Dysphonia due to unilateral vocal fold immobility (UVFI) can have detrimental effects on quality of patient daily lives. Arytenoid adduction and type I thyroplasty are widely accepted treatment methods for UVFI. However, postoperative voice does not always reach normal although dysphonia is improved to a certain degree
The goal of a corrective procedure is to move the edge of the paralyzed vocal fold closer to the midline, to facilitate glottal closure during phonation.
The ideal surgical procedure for correction of glottal incompetence would improve both sphincteric function and sound production while preserving the glottal airway.
Arytenoid adduction (AA) is used in the treatment of glottal insufficiency. Unlike medialization laryngoplasty, AA acts through direct traction on the arytenoid cartilage at the muscular process mimicking the action of the lateral cricoarytenoid muscle. AA is an important adjunct in selected cases of vocal fold paralysis.
In patients with vocal fold paralysis who have a lack of vocal process contact during phonation (large posterior gap), shortened immobile vocal fold and those with vocal folds at different levels, AA should be considered in addition to ML. Videostroboscopy often provides valuable information about vocal process contact, vocal fold height, length and therefore is useful preoperatively in assessing whether a patient may need an AA.
Other data
| Title | ARYTENOID ADDUCTION TECHNIQUE, RESULTS AND ITS RELATION TO MEDIALIZATION THYROPLASTY | Other Titles | التقريب الطرجهالى من حيث التقنية والنتائج وعلاقتها بالتقريب الانسى لعمليات الراب الدرقى صوتية | Authors | Mohamed Ibrahim Seddick | Issue Date | 2014 |
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