Adduction arytenopexy for vocal fold paralysis: indications and technique.
Adduction arytenopexy was designed as an innovation to arytenoid adduction, however the pragmatic issues regarding patient selection for these procedures has not been comprehensively assessed. A prospective examination was performed on 100 consecutive patients who had undergone laryngoplastic phonosurgical reconstruction for paralytic dysphonia. Seventy-seven of 100 (77 per cent) were judged pre-operatively to gain potentially significant phonatory enhancement from an arytenoid procedure. Fifty-six of 77 (73 per cent) underwent adduction arytenopexy; 17 of 77 (22 per cent) were judged pre-operatively to have inadequate respiratory abduction of the contralateral arytenoid and two out of 77 (three per cent) had athletic aerodynamic requirements. In another two out of 77 (three per cent), there was a chance of favourable reinnervation and thus it was not the preferred method. The majority of patients were judged pre-operatively to gain potentially substantial phonatory enhancement from an arytenoid procedure. However, in this series, approximately 25 per cent of the patients were considered to be unsuitable candidates for an arytenoid medializing procedure, primarily because it was deemed that the operation could result in an inadequate airway.
Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA. zeitels.steven@mgh.harvard.edu
Steven M
SM
Zeitels
Marcelo
M
Mauri
Seth H
SH
Dailey
D001193:Arytenoid Cartilage / Q000601:surgery*; D000075202:Contraindications; D006801:Humans; D007830:Larynx / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D018579:Patient Selection; D010699:Phonation; D011138:Polytetrafluoroethylene; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D019736:Prostheses and Implants; D013536:Suture Techniques; D014826:Vocal Cord Paralysis / Q000150:complications / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology / Q000601:surgery
D011138:Polytetrafluoroethylene