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Cancers (Basel) 2019 Jan 10;11(1). Epub 2019 Jan 10.

Department of Otorhinolaryngology, Maxillofacial, and Thyroid Surgery, Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, University of Milan, 20133 Milan, Italy.

Discrimination of the etiology of arytenoid fixation in cT3 laryngeal squamous cell carcinoma (SCC) is crucial for treatment planning. The aim of this retrospective study was to differentiate among possible causes of arytenoid fixation (edema, inflammation, mass effect, or tumor invasion) by analyzing related signal patterns of magnetic resonance (MR) in the posterior laryngeal compartment (PLC) and crico-arytenoid unit (CAU). Seventeen patients affected by cT3 glottic SCC with arytenoid fixation were preoperatively studied by state-of-the-art MR with surface coils. Read More

Ann Otol Rhinol Laryngol 2019 Jan 26;128(1):36-43. Epub 2018 Oct 26.

1 Division of Otorhinolaryngology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.

Objectives:: Laryngeal squamous cell carcinoma (LSCC) can involve different anatomic subunits with peculiar surgical and prognostic implications. Despite conflicting outcomes for the same stage of disease, the current staging system considers different lesions in a single cluster. The aim of this study was to critically discuss clinical and pathologic staging of primary and recurrent advanced LSCC in order to define current staging pitfalls that impede a precise and tailored treatment strategy. Read More

Acta Otorhinolaryngol Ital 2018 Jan 31. Epub 2018 Jan 31.

Department of Otolaryngology Head and Neck Surgery, Tri-service General Hospital, National Defense Medical Center Taipei, Taiwan, Republic of China.

A suture lateralisation (SL) instead of an endolaryngeal tissue ablation procedure under endoscopy has been utilised to treat bilateral vocal fold immobility (BVFI) since 1980. However, mechanical fixation (MF) of the cricoarytenoid joint (CAJ) has continually challenged the effectiveness of glottic dilatation both in the SL procedure and the tissue ablation procedure. From 2007 to 2015, a total of 38 patients with BVFI underwent 40 exo-endolaryngeal suture lateralisation (exoeSL) procedures and three were diagnosed with MF in our hospital. Read More

Auris Nasus Larynx 2018 Aug 5;45(4):885-889. Epub 2018 Jan 5.

Department of Otolaryngology, Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.

Surgical management of cricoarytenoid joint (CAJ) ankylosis is challenging and has the risk of worsening voice quality. In the present case, augmentation surgery was performed on the cartilaginous portion of the vocal fold in a patient with CAJ ankylosis. A 24-year-old man sustained blunt trauma to the anterior neck three years prior to developing severe breathiness. Read More

J Voice 2018 Jan 4. Epub 2018 Jan 4.

Division of Otolaryngology, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.

Objective: This study aimed to describe a graduated approach for effective transoral mobilization of cricoarytenoid joint ankylosis (CJA) in the context of the Bogdasarian system of classifying posterior glottic web-based stenosis (PGWS).

Study Design: This is a retrospective cohort study through data from medical records and operative notes. A consecutive series of 23 patients who underwent reconstructive transoral laser microsurgery for PGWS with a significant degree of CJA (Bogdasarian grade III-IV) was included in the study. Read More

Medicine (Baltimore) 2017 Nov;96(45):e8514

aDepartment of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University bDepartment of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.

Rationale: Arytenoid dislocation is very rare and may be misdiagnosed as vocal cord paralysis or a self-limiting sore throat.

Patient Concerns: A 70-year-old male (70 kg, 156 cm) was scheduled for transurethral resection of bladder tumors. A McGrath videolaryngoscope, with a basic cuffed Mallinckrodt oral tracheal tube of 7. Read More

Int J Clin Oncol 2017 Dec 17;22(6):1001-1008. Epub 2017 Jun 17.

Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Background: The aim of this study was to compare the therapeutic outcomes of total pharyngolaryngectomy with those of concomitant chemoradiotherapy in advanced hypopharyngeal cancer.

Methods: This is a retrospective multi-institutional study. The medical records of 979 patients with hypopharyngeal cancer, who were initially treated between 2006 and 2008, were reviewed. Read More

Auris Nasus Larynx 2018 Feb 14;45(1):194-199. Epub 2017 Apr 14.

Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan.

For locally advanced laryngeal cancers, the standard treatment of choice is chemoradiotherapy if organ function needs to be conserved. Surgical treatment with larynx preservation is conducted only for limited cases. For locally advanced laryngeal cancers such as those with vocal cord fixation and/or cricoid cartilage destruction, there is no apparent standardized organ-preserving surgery keeping the essential laryngeal functions, viz. Read More

Acta Otolaryngol 2017 Apr 15;137(4):403-410. Epub 2016 Dec 15.

a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.

Conclusion: The resection of the medial and lateral pyriform sinus was associated with post-operative voice impairment after TOVS. Scar contracture around the cricoarytenoid joint lead to arytenoid fixation toward lateral position, and this wound healing process caused insufficient glottis closure. Although oncological and functional outcomes of TOVS was satisfactory, surgeons should mention the risk of post-operative voice impairment in pre-operative counseling. Read More

Laryngoscope 2017 02 3;127(2):359-365. Epub 2016 Jun 3.

Department of Neurosciences DNS , Otolaryngology Section, University of Padova, Padova, Italy.

Objectives/hypothesis: To retrospectively analyze our experience of transoral laser microsurgery (TLM) for treating postoperative laryngeal obstruction (POLO) after supracricoid and supratracheal laryngectomy (open partial horizontal laryngectomy [OPHL]) types 2 and 3, and to investigate potential relationships between patients' clinical features and their functional outcomes.

Study Design: A retrospective cohort study.

Methods: The prognostic influence of clinical and surgical parameters on functional outcomes was investigated in a univariate statistical setting in terms of decannulation rate (DR), time to tracheostomy closure (TTC), and number of laser procedures required (NLP). Read More

Curr Opin Otolaryngol Head Neck Surg 2016 Apr;24(2):135-9

aDepartment of Otorhinolaryngology - Head and Neck Surgery, University of Genoa, GenoabDepartment of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.

Purpose Of Review: Transoral laser microsurgery (TLM) is widely acknowledged to offer several advantages in the treatment of early and selected intermediate-advanced laryngeal cancers. Nevertheless, a number of issues are still under debate. The purpose of this review is to discuss the reasonable limits for TLM in laryngeal cancer to highlight its most appropriate and reproducible indications, putting this therapeutic tool in the right perspective within a comprehensive frame of alternative treatment strategies such as open partial laryngectomies and nonsurgical organ preservation protocols. Read More

B-ENT 2016;12(4):271-277

Induction chemotherapy followed by supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEF) in T3NO arytenoid fixation-related glottic cancer.

Objective: Arytenoid fixation in the larynx has been considered a contraindication for performing organ preservation surgery (OPS). We present a retrospective series of cases of arytenoid fixation-related T3N0 glottic cancer treated by neoadjuvant chemotherapy followed by OPS. Read More

Ann Surg Oncol 2016 May 29;23(5):1674-83. Epub 2015 Dec 29.

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium.

Background: Tracheal autotransplantation is a reconstructive technique that allows for organ-sparing treatment of selected patients with advanced cricoid cartilage chondrosarcoma and T2 or T3 laryngeal squamous cell carcinoma (SCC) (unilateral T2 with impaired vocal fold mobility; T3 with subglottic extension and/or arytenoid cartilage fixation). This study evaluated the functional and oncologic outcomes of an optimized autotransplant technique that the authors have been using since 2003.

Methods: The study retrospectively reviewed the charts of all patients who underwent tracheal autotransplantation at the authors' center between 2003 and 2015. Read More

Cir Cir 2016 Mar-Apr;84(2):96-101. Epub 2015 Dec 19.

Departamento de Medicina Nuclear, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.

Background: The standard of care for advanced-stage laryngeal cancer is combined treatment (chemo-radiotherapy). However, the complications with this treatment are not few, mainly in swallowing. Conservative laryngeal surgery remains an effective alternative for cancer control without the complications of chemo-radiotherapy. Read More

Ann Otol Rhinol Laryngol 2014 Mar;123(3):195-205

The Department of Otolaryngology, University of Iowa, Iowa City, Iowa, USA.

Objectives: We report development of a device and technique to manage laryngeal paralysis through minimal-access arytenoid adduction (for unilateral paralysis) and arytenoid abduction (for bilateral paralysis).

Methods: A human cadaver study coupled with directed engineering was used to develop instrumentation designed to secure the muscular process of the arytenoid into favorable adducted or abducted positions. Digital video, photography, and 3-dimensional computed tomographic (CT) imaging of cadaveric larynges were done to evaluate the surgical technique. Read More

Ear Nose Throat J 2014 Jan;93(1):32-4

Department of Otolaryngology, E-Da Hospital, I-Shou University, No. 1, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan.

Vocal fold fixation as a result of trauma caused by a foreign body is rare. We report a unique case of vocal fold fixation caused by traumatic penetration of a shard of steel in a 31-year-old steelworker. While the patient was at work, an airborne projectile suddenly pierced his neck and entered his larynx, causing progressive hoarseness and dyspnea. Read More

Vestn Otorinolaringol 2013 (6):51-4

The objective of the present work was to develop a method for the modification of the vocal cord during the treatment of the patients presenting with unilateral laryngeal paralysis taking into consideration individual peculiarities of stereotopometric characteristics of the larynx in the subjects of different gender, neck structure, and body constitution. The earlier proposed method of laryngostereotopometry was employed in this study. The following body features were measured prior to surgery: the total length, acromial diameter, chest circumference, neck length and circumference; the degree of the fissure of glottis closure was measured by transnasal fibrolaryngoscopy. Read More

Laryngorhinootologie 2014 Mar 17;93(3):161-73. Epub 2013 Oct 17.

HNO, Sektion Phoniatrie, Univ.-Klinik Ulm.

Etiology of vocal fold paralysis is broad: e. g. iatrogenic/traumatic, associated with neoplasms or with systemic diseases. Read More

Otolaryngol Pol 2013 Sep-Oct;67(5):233-7. Epub 2013 Mar 21.

Katedra i Klinika Otolaryngologii Gdańskiego Uniwersytetu Medycznego, Kierownik: prof. dr hab. med. C. Stankiewicz, Gdańsk, Poland. Electronic address:

Introduction: Cartilaginous tumours of the larynx are rare. They usually involve cricoid cartilage, less frequently thyroid cartilage and other cartilages. The most significant clinical manifestations are hoarseness, dyspnea, dysphagia or a neck mass. Read More

Indian J Otolaryngol Head Neck Surg 2011 Jul 11;63(Suppl 1):55-7. Epub 2011 Apr 11.

MCV Memorial ENT Trust Hospital, Pollachi, Tamil Nadu India.

Advanced form of diffuse idiopathic skeletal hyperostosis or Forestier's disease can induce dysphagia and significant airway symptoms such as hoarseness, snoring, dyspnoea on exertion and laryngeal stridor. We have discussed the diagnosis and management of an unusual case with respiratory distress due to left cricoarytenoid joint fixation and right vocal cord paresis in conjunction with skeletal pathology. Read More

J Voice 2012 Jul 13;26(4):526-9. Epub 2011 Nov 13.

Department of Phoniatrics, ENT University Hospital Graz, Medical University Graz, Graz, Austria.

Introduction: Arytenoid adduction is a very effective procedure for medializing the posterior part of the vocal fold in vocal fold paralysis. Major drawback of the method is the technically sometimes-difficult access to the arytenoid with increased postoperative morbidity. Aim of this study was to provide basic anatomical data regarding the accessibility of the arytenoid cartilage through a thyroplasty window. Read More

Curr Opin Otolaryngol Head Neck Surg 2011 Dec;19(6):428-33

Southern Illinois University School of Medicine, Springfield, Illinois 62794-9662, USA.

Purpose Of Review: The pathophysiology of bilateral vocal fold immobility includes two broad categories: mechanical fixation and neurogenic paralysis. A mobile arytenoid can be surgically abducted, and this procedure has been reported as a treatment for patients with bilateral neurogenic laryngeal paralysis. This article reviews the theoretical basis and clinical outcomes of this procedure. Read More

Eur Arch Otorhinolaryngol 2011 Jul 15;268(7):1023-8. Epub 2011 Mar 15.

Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.

The purpose of this study was to describe a simplified arytenoid rotation technique and to test its applicability in excised human larynges. A non-absorbable monofilament thread is slung around the muscular process of the arytenoid cartilage through an external approach. During visual control through flexible endoscopy, two needles and a wire loop needle threader are the only instruments needed. Read More

Clin Rheumatol 2011 May 7;30(5):723-7. Epub 2011 Jan 7.

Department of Rheumatology, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.

The purpose of this is case-based review is to report a series of patients with rheumatoid arthritis who developed stridor and highlight this potentially life-threatening manifestation of the disease. We report three cases from the Rheumatology Department of University College Hospital, London and review the literature on the prevalence, clinical presentation, histopathological features and treatment of laryngeal involvement in rheumatoid arthritis. In two patients, emergency tracheostomy was necessary to maintain a patent airway. Read More

Gac Med Mex 2010 May-Jun;146(3):175-8

Departamento de Tumores de Cabeza y Cuello, Hospital de Oncologia, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, DF México.

Introduction: Although the possibility of developing cervical node metastases (CNM) in patients with squamous cell carcinoma of the larynx (SCCL) depends on the site of tumor origin, other factors may be associated, even in glottic tumors. The objective of this study was to determine factors associated with CNM.

Methods: We carried out a retrospective analysis of a series of patients with SCCL. Read More

Srp Arh Celok Lek 2010 Mar-Apr;138(3-4):230-2

Otorhinolaryngological Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia.

Introduction: The incidence of cricoarytenoid joint fixation in case of rheumatoid arthritis is 17 to 33%. In later stages of rheumatoid arthritis, a gradual fixation of cricoarytenoid joint develops and both halves of the larynx become less movable which calls for endotracheal intubation; while total fixation of this joint demands surgical tracheotomy. Hashimoto thyroiditis can display symptoms which are difficult to distinguish from the ones present in total fixation of cricoarytenoid joint caused by rheumatoid arthritis. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010 Jan;45(1):56-60

Department of Otorhinolaryngology Head and Neck Sugery, Beijing Tongren Hospital, Capital University of Medical Sciences, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China.

Objective: To investigate the histopathological changes in cricoarytenoid joints in 32 animal models. The characteristic histopathological changes of arytenoid cartilages after recurrent nerve paralysis were evaluated.

Methods: Sixteen dogs (32 vocal folds, 8 as normal control) were divided into different animal models of recurrent nerve paralysis as transection, half-section, ligation, or crush. Read More

Vet Immunol Immunopathol 2008 Aug 20;124(3-4):394-7. Epub 2008 May 20.

Department of Morphology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium.

This paper describes the presence of lymphoid tissue in the mucosa of the bovine larynx. A total of 15 bovine larynges were examined both macroscopically after tissue fixation in acetic acid and microscopically using histology. It was found that no paraepiglottic tonsil was present in cattle, although a few lymphoid follicles were present in the mucosa at the base of the epiglottis. Read More

Rev Laryngol Otol Rhinol (Bord) 2006 ;127(5):353-5

Clinique des Minguettes, 21 rue Commune de Paris, F-69694 Vénissieux cedex, France.

Unlabelled: In patients presenting a bilateral laryngeal immobility, the potential reversibility of certain cases, the refusal or the bad tolerance of long term tracheotomy bring up the question of the choice of the surgical technique if it is indicated.

Objectives: To report our experience with the technique of lateralization of the paralyzed vocal fold (arytenoidopexy) suggested by Lichtenberger.

Clinical Cases: After having described the technique, we report 5 cases (3 pos-thyroidectomy, I of central origine, 1 post-burn). Read More

Arch Otolaryngol Head Neck Surg 2006 Dec;132(12):1342-5

Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.

Objective: To characterize the histopathologic characteristics of the cricoarytenoid joint (CAJ) as a means to understand the mechanisms of vocal cord fixation in children after prolonged intubation.

Design: Histologic analysis of laryngeal specimens obtained from infants who had died secondary to various causes and who had been intubated from 1 to 30 days.

Main Outcome Measure: Histopathologic characteristics of CAJ. Read More

Vet Surg 2005 Nov-Dec;34(6):548-53

Clinic for Surgery and Ophthalmology, University of Veterinary Medicine, Vienna, Austria.

Objective: To report the use of a nylon suture system (Canine Cranial Cruciate Ligament Repair System; Securos Inc Veterinary Orthopedics) as a prosthesis for equine laryngoplasty.

Study Design: Experimental and prospective clinical study.

Animals: Cadaver specimens (n = 5) and 7 horses with left laryngeal hemiplegia. Read More

Laryngoscope 2005 Feb;115(2):297-300

Departments of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.

Objectives/hypothesis: The study examined preoperative clinical characteristics that can be used to predict secure inferior margins of glottic squamous cell carcinoma extending toward the cricoid cartilage when performing organ preservation surgery of the larynx.

Study Design: The study was retrospectively performed using 31 serially sectioned whole-organ total laryngectomy specimens with associated preoperative clinical data.

Methods: Histopathologic and clinical variables including true vocal cord (TVC) fixation, cricoarytenoid joint invasion, subglottic extension (SGE) of tumor, and prior radiation were examined as independent and multivariate correlates of cricoid cartilage invasion. Read More

Otolaryngol Pol 2004 ;58(4):843-9

Klinika Otorynolaryngologii i Onkologii Laryngologicznej PAM.

Rheumatoid arthritis (RA) is a systemic disease of connective tissue which affects joints lined with synovial membrane. Laryngeal joints also have such a structure. Among all reasons leading to their inflammation rheumatoid arthritis is mentioned on the first place. Read More

Lin Chuang Er Bi Yan Hou Ke Za Zhi 2003 Sep;17(9):519-21

Department of Otolaryngology, Weihai Municipal Hospital, Weihai 264200.

Objective: To explore the clinical effect on defect of post-laryngectomy partial laryngeal repaired with omohyoid myofascial flap.

Method: Twenty-four cases of supraglottic and glottic cancer were treated surgically. The tumors and involved cartilages were removed entirely. Read More

ANZ J Surg 2003 May;73(5):326-30

Sydney Voice Clinic, University of New South Wales, Sydney, New South Wales, Australia.

Background: The present retrospective study presents the outcomes of a group of 21 patients with laryngeal obstruction caused by bilateral vocal fold fixation. All of these patients were treated by laser assisted muscle tenotomy and vocal process resection - a modification of the technique described by Michael and Eugene Rontal in 1994.1

Methods: Between January 1997 and March 2002 the senior author performed muscle tenotomy and vocal process resection for bilateral vocal fold fixation on 21 patients. Read More

Ann Otol Rhinol Laryngol 2003 Feb;112(2):103-8

Department of Otorhinolaryngology, University of Cologne Medical School, Cologne, Germany.

Bilateral arytenoid cartilage fixation (ACF) closely resembles vocal cord immobility due to recurrent laryngeal nerve paralysis (RLNP). This study sought to determine the etiologic differences between these two entities and to derive conclusions about treatment. The charts of 218 consecutive adult patients with immobility of both vocal cords requiring surgery for airway restoration were reviewed. Read More

Acta Otolaryngol 2000 Mar;120(2):120-7

Kyoto University, Isshiki Clinic, Japan.

This paper reviews progress in laryngeal framework surgery since it was first reported about 25 years ago. The success of this type of surgery requires both a basic knowledge of the physiology of phonation, in order to make decisions about the surgical procedure, and surgical skill, in order to accomplish the intended procedure successfully. The main reason for hoarseness is imperfect closure of the glottis, but the second most important reason for hoarseness, increased stiffness of the vocal fold, cannot be corrected by mere medialization of the vocal fold. Read More

Vestn Otorinolaringol 2001 (3):52-4

Intralaryngeal electrostimulation of the laryngeal muscles with fluctuating currents with simultaneous mobilization of the arytenoid cartilage and paralysed vocal cord were used in 42 patients with unilateral laryngeal paralysis. The treatment was combined with phonopedic lessons. The control group consisted of 32 patients receiving standard electrostimulation with diadynamic currents. Read More

Laryngoscope 2001 Jan;111(1):44-7

Department of Otolaryngology, Medical College of Pennsylvania/Hahnemann School of Medicine, Philadelphia 19103, USA.

Objectives: To describe a new endoscopic technique for medialization of the laterally fixed arytenoid. The surgical technique, endoscopic arytenoid repositioning, is described, and the results of a series of cases are discussed.

Study Design: Retrospective chart review. Read More

Laryngoscope 2001 Jan;111(1):168-71

Department of Otolaryngology-Head and Neck Surgery, Kurume University, School of Medicine, Japan.

Laryngorhinootologie 2000 Jul;79(7):412-5

Anatomisches Institut, Christian-Albrechts-Universität Kiel.

Background: Impaired movement of the cricoarytenoid joint with hoarseness and immobility of the vocal ligament may occur as a consequence of laryngeal trauma and joint disease. Little is known to date about the cricoarytenoid joint capsule and its role in joint pathology.

Methods: The present study analyses the structure of the cricoarytenoid joint capsule by means of histological, immunohistochemical, and scanning electron microscopical methods. Read More

Acta Otolaryngol 2000 Jun;120(4):456-65

Department of Otolaryngology--Head and Neck Surgery, University of Udine, Italy.

A spectrum of treatment plans and surgical procedures is available for management of early and moderately advanced laryngeal cancer. While the approach of chemotherapy and irradiation, or irradiation alone, followed by total laryngectomy for failure is often employed in practice by present day clinicians, the options of conventional conservation surgery (CCS), transoral endoscopic laser surgery (TLS) and supracricoid partial laryngectomy (SCPL) provide a wide choice of treatments that may help attain the goal of cure with preservation of laryngeal function and integrity of the airway. While CCS has been supplanted for many early-stage lesions by TLS and for more advanced stages by SCPL, centres throughout the world have reported favourable results with CCS, which is often modified to include resection of more extensive tumours than was previously possible. Read More

Vet Surg 2000 Jul-Aug;29(4):326-34

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

Objective: To examine the effect of cordopexy, laryngoplasty, and cordopexy combined with a modified laryngoplasty on airway mechanics.

Study Design: Experimental airway mechanics were determined by subjecting equine cadaveric larynges to airflows similar to inspiratory airflow of exercising horses.

Animals Or Sample Population: Twenty equine larynges. Read More

Laryngoscope 2000 Jul;110(7):1082-5

Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.

Objectives: Airway compromise arising from thyroplasty procedures including Isshiki type I through IV thyroplasties, arytenoid adduction, and arytenoid fixation is uncommon yet potentially life threatening. Identification of incidence of obstruction and probable causes is important for preoperative planning, consultation, and postoperative care.

Study Design: Retrospective review of all thyroplasty operations, including arytenoid adduction and arytenoid fixation. Read More

Laryngoscope 1999 Feb;109(2 Pt 1):279-83

Department of Otolaryngology, SUNY Health Sciences Center, Syracuse, New York 13210, USA.

Objective/hypothesis: To demonstrate denervation atrophy of laryngeal muscles in a case of gout involving the cricoarytenoid joint.

Methods: The posterior cricoarytenoid (PCA) and arytenoideus (A) muscles from a 72-year-old man with extensive gout were compared with those from a normal adult larynx (age and sex unknown) using stereologic techniques for changes in muscle composition and fiber diameter.

Results: The PCA and A muscles in the gout specimen contained changes Indicative of muscle degeneration. Read More

J Otolaryngol 2000 Feb;29(1):13-6

Department of Otolaryngology-Head and Neck Surgery, Rambam Medical Center, Haifa, Israel.

Objective: Arytenoidectomy is indicated in cases of bilateral median vocal cord paralysis (most commonly due to recurrent laryngeal nerve paralysis), ankylosis of the cricoarytenoid joint due to arthritis, and tumours of the arytenoid cartilage. We propose the use of the submucosal approach, to excise the arytenoid cartilage in cases of vocal cord paralysis. We present the surgical technique and review the history and relevant literature, as well as the pros and cons of various surgical techniques for arytenoidectomy. Read More

Otolaryngol Head Neck Surg 1999 Dec;121(6):760-5

University of Washington, Seattle 98195, USA.

Bilateral vocal cord immobility can be life threatening for some patients. Others, who have an open glottic chink, may have a breathy dysphonia, intermittent dyspnea, and stridor. These signs and symptoms may also be found in a number of other conditions that cause weakness or paradoxical motion of the vocal cords that mimics paralysis. Read More

Head Neck 1999 Dec;21(8):743-50

Department of Oto-Rhino-Laryngology, University of Innsbruck, Austria.

Background: The increasing application of sophisticated methods of laryngeal framework surgery requires a profound knowledge of the size and proportions of the human larynx and its cartilaginous components. Only inadequate data regarding this subject have so far been accessible. The aim of this study was to collect exact and reliable morphometric data of the human laryngeal framework. Read More

Anesthesiology 1999 Sep;91(3):659-66

Department of Anatomy, Christian Albrecht University of Kiel, Germany.

Background: Impaired movement of the cricoarytenoid joint with hoarseness and immobility of the vocal ligament can occur as a consequence of endotracheal intubation. The biomechanics and pathomechanism of cricoarytenoid subluxation have not been demonstrated to date.

Methods: The present study attempts to simulate the trauma that has been associated with arytenoid cartilage subluxation in intubation trials on 37 unfixed larynges in cadavers from persons aged 25 to 89 years. Read More

Otolaryngol Head Neck Surg 1999 Sep;121(3):180-4

Division of Head and Neck Surgery, University of California, Los Angeles 90095, USA.

Laryngeal electromyography has been used clinically to differentiate neuromuscular pathology from other causes of vocal fold immobility such as arytenoid dislocation, tumor invasion, or cricoarytenoid joint fixation. Electromyography has also been used to predict the prognosis for nerve recovery in laryngeal paralysis. Existing electromyographic techniques either record activity with voluntary motion or study nerve conduction. Read More