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Beijing Da Xue Xue Bao Yi Xue Ban 2020 Sep;53(2):337-340

Department of Anesthesiology, First Hospital, Peking University, Beijing 100034, China.

Objective: To assess the incidence of postoperative vocal cord immobility in patients following endotracheal intubation underwent general anesthesia.

Methods: We retrospectively enrolled patients who underwent surgical procedures with endotracheal intubation under general anesthesia from January 2014 to December 2018 in Peking University First Hospital. Demographic and treatment data were obtained for patients with hoarseness and vocal cord fixation. Read More

J Voice 2021 Mar 19. Epub 2021 Mar 19.

Department of Otolaryngology Head and Neck Surgery, Taipei Tzu Chi Hospital, Buddist Tzu Chi Medical Foundation, New Taipei City, School of Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China.

Objective: In order to correct the varying vocal fold positions to meet the various clinical requirements in patients with bilateral vocal fold immobility, we present pertinent surgical methods to treat them.

Materials And Methods: From 2005 to 2020, 115 patients diagnosed with bilateral vocal fold immobility were addressed for ventilation in 89 patients and for phonation in 26 patients. In the ventilation surgery group, all the neurogenic subjects received mere suture lateralization (SL) procedures and the mechanical ones underwent arytenoid release (AR) plus SL procedures if the cricoarytenoid joint fixation (CAJF) could be confirmed before operation. Read More

J Neurovirol 2021 02 3;27(1):186-190. Epub 2021 Feb 3.

Departments of Otolaryngology, Head and Neck Surgery, Radiology, and Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

Clarifying temporal changes in magnetic resonance imaging (MRI) offers a good chance to understand the pathology of neural lesions; however, such information is scarce in varicella zoster virus (VZV) neuropathies for the glossopharyngeal and vagus nerves. Here, we present the changes in sequential MR images of such a pathology over a period of 12 months from symptom onset.A 27-year-old woman with difficulty in swallowing and hoarseness due to a palatal palsy and arytenoid fixation on the left presented 2 days after onset. Read More

Vet World 2020 Oct 13;13(10):2142-2149. Epub 2020 Oct 13.

Center for Agricultural and Environmental Sciences, Federal University of Maranhão, Chapadinha, Brazil.

Background And Aim: From a biomedical point of view, the value of marsupials as a model of primitive mammals is indisputable. Among its species, the possum is a model that allows the study of the ontogeny of different organic systems, as well as their physiological aspects. The relevance of anatomical, functional, evolutionary, and phylogenetic study of marsupials for the development of comparative morphology is extensively documented in the literature. Read More

AANA J 2020 Dec;88(6):459-463

is a staff nurse anesthetist at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Email:

This case report describes a right arytenoid dislocation after emergency fiberoptic nasotracheal intubation in a patient with angioedema. The patient returned to the emergency department multiple times with classic symptoms of arytenoid dislocation, complicated by resultant postinjury laryngeal edema and poorly controlled laryngopharyngeal reflux. The arytenoid injury was not initially recognized, which delayed treatment. Read More

Adv Otorhinolaryngol 2020 9;85:85-97. Epub 2020 Nov 9.

Department of Otolaryngology, Centre Hospitalier Luxembourg, Luxembourg, Luxembourg.

Vocal fold immobility can be either unilateral or bilateral and partial or complete. The aim of this chapter is to discuss the management of unilateral paresis using medialization thyroplasty with or without arytenoid adduction as a means of treating neurogenic causes as opposed to mechanical fixation. Medialization thyroplasty is an open surgical procedure that is performed under local or general anesthesia. Read More

Mov Disord 2020 12 5;35(12):2174-2183. Epub 2020 Aug 5.

Department of Neurology, University Hospital Münster, Münster, Germany.

Background: Multiple system atrophy (MSA) is a rare neurodegenerative disorder, and its parkinsonian variant can be difficult to delineate from Parkinson's disease (PD). Despite laryngeal dysfunction being associated with decreased life expectancy and quality of life, systematic assessments of laryngeal dysfunction in large cohorts are missing.

Objectives: The objective of this study was to systematically assess laryngeal dysfunction in MSA and PD and identify laryngeal symptoms that allow for differentiating MSA from PD. Read More

Laryngoscope 2021 05 5;131(5):1078-1080. Epub 2020 Aug 5.

Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, U.S.A.

A 77-year-old male underwent open reduction and internal fixation with placement of odontoid screws after sustaining C1 arch and odontoid fractures in a fall 14 months prior to presentation to the laryngology clinic for combined surgery with orthopedics. Serial imaging after the initial surgery demonstrated loosening of a screw and its entry into the pharyngeal lumen. The patient reported odynophagia, dysphagia, and dysphonia. Read More

J Laryngol Otol 2019 Oct 7:1-4. Epub 2019 Oct 7.

Department of Otolaryngology, Toho University Omori Medical Center, Tokyo, Japan.

Objective: This study investigated the position of adduction thread attachment, pulling direction and fixation position in revision arytenoid adduction surgery performed in two patients with left vocal fold palsy in whom satisfactory speech improvement had not been obtained by arytenoid adduction and type 1 thyroplasty.

Methods: Revision arytenoid adduction surgery was performed with the vocal fold in the midline position in both cases. A type 1 thyroplasty procedure was subsequently added in one case because of worsened quality of speech following arytenoid adduction. Read More

J Voice 2021 Jan 23;35(1):151-155. Epub 2019 Jul 23.

Department of Otolaryngology, Boston Medical Center; Boston, Massachusetts.

Objective: Vocal fold paralysis may result from surgical complications, trauma, tumor, or unknown causes. When both cords are affected, paramedian fixation can lead to life-threatening obstruction. Current treatments, including tracheostomy, cordotomy, and arytenoidectomy, compromise speech and swallow function to maintain a safe airway. Read More

Front Neurol 2019 26;10:241. Epub 2019 Mar 26.

Hospital for Movement Disorders/Parkinson's Disease, Beelitz-Heilstätten, Germany.

In its early stages multiple system atrophy (MSA), a neurodegenerative movement disorder, can be difficult to differentiate from idiopathic Parkinson's disease (PD), and emphasis has been put on identifying premotor symptoms to allow for its early identification. The occurrence of vegetative symptoms in addition to motor impairment, such as orthostatic hypotension and neurogenic bladder dysfunction, enable the clinical diagnosis in the advanced stages of the disease. Usually with further disease progression, laryngeal abnormalities become clinically evident and can manifest in laryngeal stridor due to impaired vocal fold motion, such as vocal fold abduction restriction, mostly referred to as vocal fold paresis, or paradoxical vocal fold adduction during inspiration. Read More

Cancers (Basel) 2019 Mar 13;11(3). Epub 2019 Mar 13.

Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, 10060 Candiolo (TO), Italy.

The aim of this retrospective study was to identify different radiological features in intermediate⁻advanced laryngeal cancer (LC) associated with arytenoid fixation, in order to differentiate cases still safely amenable to conservative treatment by partial laryngectomy or chemoradiotherapy. : 29 consecutive patients who underwent open partial horizontal laryngectomies (OPHLs), induction chemotherapy followed by radiotherapy in the case of >50% response (IC + RT) or total laryngectomy were classified as: pattern I (supraglottic LC fixing the arytenoid due to weight effect), pattern II (glottic LC involving the posterior paraglottic space and spreading toward the crico-arytenoid joint and infraglottic extension <10 mm), pattern III (glottic-infraglottic LC involving the crico-arytenoid joint and infraglottic extension >10 mm) and pattern IV (transglottic and infraglottic LC with massive crico-arytenoid unit involvement, reaching the hypopharyngeal submucosa). All glottic cancers treated with surgery were studied by a cross sectional approach. Read More

Ann Otol Rhinol Laryngol 2019 May 24;128(5):420-425. Epub 2019 Jan 24.

1 Department of Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.

Objective: This anatomic study considers the feasibility of a posterior endoscopic approach to the cricoarytenoid joint (CAJ) by describing relationships between readily identifiable anatomic landmarks and the posterior CAJ space in cadaver larynges.

Study Design: Anatomic study.

Methods: Six adult cadaver larynges (2 male, 4 female) were studied. Read More

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 2019 Feb 31;39(1):18-21. Epub 2018 Jan 31.

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

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 2019 May 4;33(3):375-380. 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

J Voice 2019 Mar 24;33(2):162-168. Epub 2017 Nov 24.

Center for Clinical Neurosciences, Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Deutsche Stimmklinik, Hamburg, Germany.

Principles in medializing and lateralizing vocal folds have not changed a lot within the last decades (Isshiki et al, 1974; Bruenings, 1911). We present a feasibility study for a completely new approach to perform medialization and lateralization of immobile vocal folds. The method was tested on 20 human larynges by inserting a 21G needle into the vocal fold, medializing (or, in other cases, lateralizing) the vocal cord and fixing the needle at the cricoid cartilage posteriorly. Read More

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

Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University Department 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