Minimally invasive device to effect vocal fold lateralization.
Despite many operative procedures focused on vocal fold lateralization, none has achieved an acceptable level of dependability. Bilateral vocal fold abductor paralysis is treated by arytenoidectomy, cordotomy, suture lateralization, or partial cordectomy. Tracheotomy remains the gold standard for maximizing the airway and preserving phonatory function. We have developed a device that is minimally invasive, tunable, and reversible, with the potential for lateralization or medialization of the vocal process. The device consists of a polyethylene collar, a Vitallium cam, and a double-helix core for engaging soft tissue. It is introduced through a circular opening in the thyroid cartilage by a modified thyroplasty approach. Both the first and second iterations of this device have been evaluated for clinical effectiveness in 9 sheep by means of photographic and video documentation. Effectiveness in humans is currently being assessed. The results of the animal study permit us to have substantial optimism with respect to the clinical application of this device.
Cummings
C W
CW
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland 21287, USA.
Redd
E E
EE
Westra
W H
WH
Flint
P W
PW
D000367:Age Factors; D000818:Animals; D005336:Fiber Optic Technology / Q000379:methods; D007828:Laryngoscopy / Q000379:methods; D007831:Larynx, Artificial; D019060:Minimally Invasive Surgical Procedures; D010699:Phonation / Q000502:physiology*; D019919:Prosthesis Implantation; D012756:Sheep; D013957:Thyroid Cartilage / Q000601:surgery; D014826:Vocal Cord Paralysis / Q000601:surgery*