Development of endoscopic arytenoid adduction using cricoid implant.
OBJECTIVE
We sought to develop a less-invasive alternative to conventional arytenoid adduction using a cricoid implant.


METHODS
We performed a preliminary study with excised human and canine larynges. A nail-shaped stainless steel rod and an insertion device were designed for an in vivo animal trial. After unilateral recurrent laryngeal denervation surgery in 5 adult mongrel dogs, the implants were inserted endoscopically through a small mucosal incision over the cricoarytenoid joint. Acoustic and aerodynamic data were obtained from each animal before serial euthanasia followed by examination of the excised larynges.


RESULTS
The canine cricoid cartilage demonstrated adequate marrow space for implantation. We found that the arytenoid cartilage was successfully medialized and tightly fixed over a sufficient period of time just by inserting an implant in the cricoid cartilage. The animal study showed that the implantation procedure was relatively easy and relatively safe. Acoustic and aerodynamic studies confirmed the functional improvement of the voice. Histopathologic study revealed a favorable tissue response to the implant.


CONCLUSIONS
Endoscopic arytenoid adduction using a cricoid implant is feasible and could be a noninvasive surgical option for the treatment of unilateral vocal fold paralysis.
Kwon
Tack-Kyun
TK
Department of Otorhinolaryngology, College of Medicine, Seoul National University, Seoul, Korea.
Jeong
Woo-Jin
WJ
Sung
Myung-Whun
MW
Kim
Kwang Hyun
KH
D000818:Animals; D001193:Arytenoid Cartilage / Q000601:surgery*; D002102:Cadaver; D003413:Cricoid Cartilage / Q000601:surgery*; D004195:Disease Models, Animal; D004285:Dogs; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*