title: Arytenoid adduction combined with medialization laryngoplasty under general anesthesia using a laryngeal mask airway.
abstract: OBJECTIVE
  Laryngeal framework surgery is usually performed under local anesthesia but cannot be tolerated by some patients. To develop a new procedure for these patients, we evaluated voice outcomes after arytenoid adduction combined with medialization laryngoplasty under general anesthesia using a laryngeal mask airway (LMA) for unilateral vocal cord paralysis.
  
  
  METHODS
  Eleven consecutive patients with severe unilateral vocal cord paralysis, with a maximum phonation time of less than 5 seconds, underwent arytenoid adduction combined with medialization laryngoplasty under general anesthesia using an LMA. Each paralyzed vocal cord was observed by intraoperative videolaryngoscopy. The vocal cord was moved to the position where the best vocal outcome could be expected, according to 3 parameters obtained from glottal images.
  
  
  RESULTS
  All patients achieved a maximum phonation time of more than 11 seconds. The mean airflow rate, which ranged from 550 to 1000 mL/s before surgery, improved to less than 390 mL/s. Perceptual evaluation using the grade, roughness, breathiness, asthenia and strain scale also improved significantly.
  
  
  CONCLUSIONS
  These results were equivalent to those of previous reports of surgeries performed under local anesthesia. Intraoperative endoscopic vocal cord observation through the LMA may have contributed to the positive results.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Jichi Medical University Saitama Medical Center, Saitama City, Saitama, Japan. kanatake@omiya.jichi.ac.jp
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Mariko
authors.initials: M
authors.lastname: Hara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shinnabe
authors.forename: Gen
authors.initials: G
authors.lastname: Kusaka
authors.forename: Takanori
authors.initials: T
authors.lastname: Murayama
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Iino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods*; D001193:Arytenoid Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017214:Laryngeal Masks; D058753:Laryngoplasty / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010699:Phonation / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality