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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 -
Laryngoscope Investigative... Jun 2024Cartilaginous tumors of the larynx are rare, representing less than 1% of all laryngeal tumors. Chondromas are benign mesenchymal tumors characterized by a slow-paced... (Review)
Review
OBJECTIVE
Cartilaginous tumors of the larynx are rare, representing less than 1% of all laryngeal tumors. Chondromas are benign mesenchymal tumors characterized by a slow-paced growth, primarily originated in the cricoid cartilage, followed by the thyroid, arytenoid, and epiglottic cartilages. This scoping review aims to understand the extent of evidence on the epidemiology, clinical characteristics, morbidity, and recurrence of the laryngeal chondroma (LC).
DATA SOURCES
MEDLINE (Ovid), Embase (Elsevier), Web of Science (Clarivate), Cochrane Central Register of Controlled Trials and Systematic Reviews, Lilacs, Scopus, and Google Scholar databases.
REVIEW METHODS
The scoping review was conducted from 1816 to 2023, for observational studies describing LC. Titles and abstracts were screened for relevance, followed by an evaluation of the full text for eligibility. The data were collected from the qualifying articles, and a narrative summary of the outcomes was prepared.
RESULTS
One hundred and nineteen studies met the inclusion criteria. Ninety-four case reports, 22 case series, and 3 cohorts. Two hundred and four participants with a diagnosis of LC were described. Male:female ratio was 2.8:1. The most common localization was the cricoid (113; 47.08%), followed by the thyroid (45; 18.75%), and the arytenoid cartilage (27; 11.25%). Dyspnea (78.85%) and hoarseness (74.28%) were the most reported symptoms. The recurrence rate was 11.25%, and complications were uncommon following the resection.
CONCLUSION
This scoping review found a low-frequency rate over all the cartilaginous laryngeal tumors. Most patients were treated with resection, with a low rate of malignancy conversion. This population has low attributable mortality, morbidity, and recurrence according to the current literature.
PubMed: 38835336
DOI: 10.1002/lio2.1265 -
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 -
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 -
Ear, Nose, & Throat Journal Aug 2014
Topics: Adult; Arytenoid Cartilage; Chondroma; Dysphonia; Female; Humans; Laryngeal Neoplasms
PubMed: 25181657
DOI: 10.1177/014556131409300805 -
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,... Dec 2018Otolaryngologists commonly observe asymmetrical movements of the arytenoid cartilages, but few authors have described the clinical implications of this asymmetry,...
INTRODUCTION
Otolaryngologists commonly observe asymmetrical movements of the arytenoid cartilages, but few authors have described the clinical implications of this asymmetry, especially in singers.
OBJECTIVES
The aim of this study was to determine the epidemiological and clinical characteristics of arytenoid asymmetry in adduction in a group of healthy opera singers and to evaluate the impact of this asymmetry on the voice.
PATIENTS AND METHODS
The medical charts and laryngeal video recordings of 245 healthy opera singers were retrospectively reviewed. Arytenoid asymmetry was defined in relation to the position of the corniculate cartilages, cuneiform cartilages and aryepiglottic angle.
RESULTS
The subjects had a mean age of 38.54years (range: 18 to 85 years) and presented a male-to-female sex ratio of 1.02. About 5% of subjects had a history of smoking. The most common vocal symptoms were occasional dysphonia (4%), followed by vocal fatigue (2%) and pharyngeal dryness (2%). Arytenoid asymmetry was slightly more common in males (50.6%) and predominantly affected the right side (64.5%). The most common form of asymmetry was cuneiform asymmetry (37.5%), followed by aryepiglottic angle asymmetry in 33.1% of cases and corniculate asymmetry in 29.4% of cases. Mild asymmetry was observed in the majority of cases. No correlation was observed between arytenoid asymmetry and vocal symptoms.
CONCLUSION
Almost one out of two singers was likely to present arytenoid asymmetry in adduction. The presence of this asymmetry does not appear to be correlated with any vocal symptoms.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Arytenoid Cartilage; Female; Humans; Laryngoscopy; Male; Middle Aged; Occupational Diseases; Retrospective Studies; Singing; Video Recording; Voice Disorders; Young Adult
PubMed: 30217681
DOI: 10.1016/j.anorl.2018.08.014 -
Medical Science Monitor : International... Aug 2014Intubation trauma is the most common cause of arytenoid dislocation. The aim of this study was to investigate the diagnosis and treatment of arytenoid cartilage...
BACKGROUND
Intubation trauma is the most common cause of arytenoid dislocation. The aim of this study was to investigate the diagnosis and treatment of arytenoid cartilage dislocation from external blunt laryngeal trauma in the absence of laryngeal electromyography (LEMG) and to explore the role of early attempted closed reduction in arytenoids cartilage reposition.
MATERIAL AND METHODS
This 15-year retrospective study recruited 12 patients with suspected arytenoid dislocation from external blunt laryngeal trauma, who were evaluated through 7 approaches: detailed personal history, voice handicap index (VHI) test, indirect laryngoscope, flexible fiberoptic laryngoscope, video strobolaryngoscope, and/or high-resolution computed tomography (CT), and, most importantly, the outcomes after attempted closed reduction under local anesthesia. They were divided into satisfied group (n=9) and dissatisfied group (n=3) based on their satisfied with voice qualities at 1 week after the last closed reduction manipulation.
RESULTS
Each patient was diagnosed with arytenoid dislocation caused by external blunt laryngeal trauma. In the satisfied group, VHI scores and maximum phonation time (MPT) at 1 week after the last reduction were significantly improved compared with those before the procedure (P<0.05). Normal or improved mobility and length of the affected vocal fold were also noted immediately after the end of the last closed reduction. The median time interval between injury and clinical intervention in satisfied group was 43.44±34.13 days, much shorter than the median time of 157.67±76.07 days in the dissatisfied group (P<0.05).
CONCLUSIONS
Multimodality assessment protocols are essential for suspected arytenoid dislocation after external blunt laryngeal trauma. Early attempted closed reduction should be widely recommended, especially in health facilities without LEMG, mainly, because it could be helpful for early diagnosis and treatment of this disease. In addition, early closed reduction could also improve the success of arytenoid reduction.
Topics: Adult; Arytenoid Cartilage; Electromyography; Female; Humans; Joint Dislocations; Larynx; Male; Middle Aged; Phonation; Time Factors; Tomography, X-Ray Computed; Vocal Cords; Wounds, Nonpenetrating; Young Adult
PubMed: 25150338
DOI: 10.12659/MSM.890530