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Journal of Feline Medicine and Surgery May 2023The aim of this study was to evaluate two unilateral laryngoplasty (arytenoid lateralisation) techniques for use in the surgical management of laryngeal paralysis in...
OBJECTIVES
The aim of this study was to evaluate two unilateral laryngoplasty (arytenoid lateralisation) techniques for use in the surgical management of laryngeal paralysis in cats.
METHODS
Left cricoarytenoid abduction (lateralisation) was performed in 20 ex vivo cat larynges; 10 following complete cricoarytenoid disarticulation (group LAA-dis) and 10 following no cricoarytenoid disarticulation (group LAA-nodis). For both groups, left arytenoid abduction (LAA) was measured in the resting and postoperative larynges using image analysis software. Measurements were evaluated using the Mann-Whitney U-test. For both groups, dorsal images of the postoperative larynges were assessed visually for evidence of epiglottic coverage of the entrance to the larynx.
RESULTS
The mean percentage increase in LAA was 311.5% and 199.4% ( <0.006) for group LAA-dis (complete cricoarytenoid disarticulation) and group LAA-nodis (no cricoarytenoid disarticulation), respectively. In both groups, there was no evidence of a lack of epiglottic coverage of the entrance of the larynx for any of the postoperative larynges.
CONCLUSIONS AND RELEVANCE
Placement of a single, tensioned suture between the muscular process of the left arytenoid cartilage and the caudolateral aspect of the ipsilateral cricoid cartilage (unilateral cricoarytenoid lateralisation) resulted in abduction of the left arytenoid cartilage and a corresponding increase in the area of the rima glottidis on the operated side. The clinical significance of the difference in outcome between left cricoarytenoid abduction following complete cricoarytenoid disarticulation and abduction following no cricoarytenoid disarticulation remains unclear, and both might be considered appropriate for the surgical management of laryngeal paralysis in the cat.
Topics: Cats; Animals; Arytenoid Cartilage; Vocal Cord Paralysis; Laryngoplasty; Larynx; Glottis; Suture Techniques; Cat Diseases
PubMed: 37204131
DOI: 10.1177/1098612X231168004 -
Indian Journal of Otolaryngology and... Dec 2022The chondromas of laryngeal cartilage constitute less than 1% of common mesenchymal tumors of the larynx. 70-75% of chondroma is located at the endolaryngeal surface of...
The chondromas of laryngeal cartilage constitute less than 1% of common mesenchymal tumors of the larynx. 70-75% of chondroma is located at the endolaryngeal surface of the cricoid cartilage. Here is a case report of the chondroma of arytenoid cartilage-a rare site of occurrence. A middle aged male patient, presented to the outpatient department of otorhinolaryngology with a history of hoarseness of voice. On Flexible laryngoscopy [Pentax, Tokyo, Japan], the right vocal cord was found to be immobile along with a smooth bulge noted over the arytenoid cartilage. The computerized tomography scan of the neck showed a well-defined peripherally calcified lesion arising from the superior aspect of right arytenoid cartilage possibly chondroma. Patient underwent microlaryngeal surgery and sub mucosal excision of the arytenoid mass which was confirmed as chondroma on histopathological examination. High degree of suspicion is required while examining a patient with hoarseness of voice and one should have chondroma as one of the differential diagnosis.
PubMed: 36742926
DOI: 10.1007/s12070-021-02879-0 -
PloS One 2020Brachycephalic airway syndrome (BAS) is a well-established cause of respiratory distress in dogs. BAS without surgical correction results in eventual laryngeal collapse....
Brachycephalic airway syndrome (BAS) is a well-established cause of respiratory distress in dogs. BAS without surgical correction results in eventual laryngeal collapse. Arytenoid lateralization has been used to treat severe laryngeal collapse with some highly variable results. Chondromalacia and decreased stiffness of the arytenoid cartilage has been postulated a source of failure after arytenoid lateralization but no report of the histological characteristics and mechanical strength of arytenoid cartilage in brachycephalic dogs has been reported. Here we report histological and mechanical features in arytenoid cartilage of brachycephalic dogs. We identified the arytenoid cartilage in brachycephalic dogs presented degenerative histological characteristics and decreased load to failure and stiffness compared to that in non-brachycephalic dogs. Together, these observations suggest that degenerative condition of arytenoid cartilage in brachycephalic dogs could contribute to chondromalacia and mechanical weakness of arytenoid cartilage and result in cause of failure after arytenoid lateralization.
Topics: Airway Obstruction; Animals; Arytenoid Cartilage; Dog Diseases; Dogs; Pilot Projects; Tensile Strength
PubMed: 32941546
DOI: 10.1371/journal.pone.0239223 -
Ear, Nose, & Throat Journal Mar 2022Arytenoid dislocation and subluxations commonly are reduced surgically using Holinger and straight Miller-3 laryngoscopes. We present a case of arytenoid cartilage...
Arytenoid dislocation and subluxations commonly are reduced surgically using Holinger and straight Miller-3 laryngoscopes. We present a case of arytenoid cartilage subluxation returned to good position using a 28-Jackson dilator. A 66-year-old man was diagnosed previously with right vocal fold paresis and left vocal fold paralysis following a motor vehicle accident that required a 14-day intubation and tracheotomy maintained for 3 weeks. Evaluation by strobovideolaryngoscopy 3 months following the accident showed severe left vocal fold hypomotility and arytenoid height disparity; laryngeal electromyography showed only mild-to-moderate decreased recruitment in laryngeal muscles. No abnormalities were appreciated on neck computed tomography. Upon palpation of both arytenoid cartilages in the operating room, the left joint was found to be subluxed anteriorly and immobile. A 28-Jackson dilator was used to mobilize and reduce the left arytenoid cartilage, and steroid was injected into the cricothyroid joint. Increased mobility was obtained in the operating room and the patient reported significant improvement in his voice. Six months later, we saw improvement in arytenoid height disparity and left vocal fold movement, better glottic closure, and voice handicap index was improved. A 28-Jackson dilator can be used to manipulate the cricoarytenoid joint without trauma to the vocal process.
Topics: Aged; Arytenoid Cartilage; Humans; Laryngeal Muscles; Laryngoscopes; Male; Vocal Cord Paralysis; Vocal Cords
PubMed: 32804570
DOI: 10.1177/0145561320946901 -
European Annals of Otorhinolaryngology,... Sep 2019Arytenoid dislocation is a rare occurrence, for which the pathophysiology is still unclear.
INTRODUCTION
Arytenoid dislocation is a rare occurrence, for which the pathophysiology is still unclear.
METHODS
We report here an unusual case of spontaneous arytenoid dislocation, which casts doubts on the prevailing classical theory of hemarthrosis.
RESULTS AND CONCLUSIONS
This case and a review of the literature suggest that arytenoid dislocation could be linked to congenital or acquired arytenoid instability, thus facilitating arytenoid dislocation after even minor trauma. Once the diagnosis is established, we recommend to first attempt reduction, followed by speech therapy, though underlying diseases should be researched.
Topics: Adult; Arytenoid Cartilage; Deglutition Disorders; Dysphonia; Endoscopy; Humans; Joint Dislocations; Male; Neck Pain; Tomography, X-Ray Computed
PubMed: 30910365
DOI: 10.1016/j.anorl.2019.02.018 -
Animals : An Open Access Journal From... Apr 2022Stage III laryngeal collapse is defined as the collapse of the corniculate processes of the arytenoid cartilages and the destructuration of the dorsal portion of the...
Stage III laryngeal collapse is defined as the collapse of the corniculate processes of the arytenoid cartilages and the destructuration of the dorsal portion of the rima glottidis. The primary cause is chronic upper airway obstruction, and the condition is often present in brachycephalic dogs. The treatment is still controversial; the patients are generally treated with a permanent tracheostomy. This article reports the authors' experience with 16 dogs affected by stage III laryngeal collapse treated with subtotal epiglottectomy and the ablation of unilateral arytenoid cartilage. Before the surgery, all of the dogs underwent an effort test to classify the clinical severity of the disease and an endoscopic examination of the airways to determine the stage of severity of the laryngeal collapse. One month after surgery, the effort test was repeated in order to evaluate the clinical outcome. One year after surgery, the owners of 12 patients rated their dogs as follows: excellent in five cases, good in five cases, and fair in two cases. According to this pilot study, epiglottectomy associated with the photoablation of unilateral arytenoid cartilage increases airway flow, and thus may be considered a valid surgical procedure to treat dogs affected by grade III laryngeal collapse.
PubMed: 35565545
DOI: 10.3390/ani12091118 -
Cartilage Jul 2019The larynx sometimes requires repair and reconstruction due to cancer resection, trauma, stenosis, or developmental disruptions. Bioengineering has provided some... (Review)
Review
The larynx sometimes requires repair and reconstruction due to cancer resection, trauma, stenosis, or developmental disruptions. Bioengineering has provided some scaffolding materials and initial attempts at tissue engineering, especially of the trachea, have been made. The critical issues of providing protection, maintaining a patent airway, and controlling swallowing and phonation, require that the regenerated laryngotracheal cartilages must have mechanical and material properties that closely mimic native tissue. These properties are determined by the cellular and proteomic characteristics of these tissues. However, little is known of these properties for these specific cartilages. This review considers what is known and what issues need to be addressed.
Topics: Arytenoid Cartilage; Bioengineering; Cartilage; Cricoid Cartilage; Epiglottis; Female; Humans; Larynx; Male; Proteomics; Regenerative Medicine; Thyroid Cartilage; Tissue Engineering; Tissue Scaffolds; Trachea; Young Adult
PubMed: 29322878
DOI: 10.1177/1947603517749921 -
Ear, Nose, & Throat Journal Feb 2024Vocal fold process avulsion results from trauma that detaches the vocal process and thyroarytenoid muscle from the body of the arytenoid cartilage. Vocal fold laxity...
Vocal fold process avulsion results from trauma that detaches the vocal process and thyroarytenoid muscle from the body of the arytenoid cartilage. Vocal fold laxity often causes severe dysphonia. Findings can be subtle. A high index of suspicion often permits diagnosis and effective surgical repair.
PubMed: 38323380
DOI: 10.1177/01455613241226860