title: In vitro evaluation of anatomic landmarks for the placement of suture to achieve effective arytenoid cartilage abduction by means of unilateral cricoarytenoid lateralization in dogs.
abstract: OBJECTIVE
  To evaluate anatomic landmarks to define the ideal suture placement location to achieve appropriate and consistent arytenoid cartilage abduction via unilateral cricoarytenoid lateralization (UCL) in dogs.
  
  
  METHODS
  6 cadaveric canine larynges.
  
  
  METHODS
  Laryngeal airway resistance (LAR) was determined for each specimen before (baseline) and after suture placements with the epiglottis open and closed. To achieve UCL, suture was placed through the cricoid cartilage just caudal to the cricoarytenoid articulation (suture placement position [SPP] 1), one-fourth of the distance caudally between the cricoarytenoid and cricothyroid articulations (SPP 2), and three-fourths of the distance caudally between the cricoarytenoid and cricothyroid articulations (SPP 3). The LAR was again calculated after tensioning of each suture separately.
  
  
  RESULTS
  With a closed epiglottis, median LAR was 30.0, 20.4, 11.4, and 3.3 cm H2O/L/s at baseline and SPPs 1, 2, and 3, respectively. After UCL at SPP 1, LAR with the epiglottis closed was not significantly different from that at baseline. With an open epiglottis, median LAR was 2.0, 0.4, 0.2, and 0.0 cm H2O/L/s at baseline and SPPs 1, 2, and 3, respectively. After UCL at SPPs 1, 2, or 3, LAR with an open epiglottis was significantly lower than that at baseline.
  
  
  CONCLUSIONS
  Results indicated that placement of suture through the cricoid cartilage at the caudal border of the cricoarytenoid articulation was appropriate to sufficiently reduce LAR without increasing the risk of aspiration pneumonia through overabduction of the arytenoid cartilage.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Gauthier
authors.forename: Eric
authors.initials: E
authors.lastname: Monnet
mesh_terms: D000403:Airway Resistance / Q000502:physiology; D059925:Anatomic Landmarks / Q000033:anatomy & histology*; D000818:Animals; D001193:Arytenoid Cartilage / Q000601:surgery*; D002102:Cadaver; D003413:Cricoid Cartilage / Q000601:surgery; D004285:Dogs / Q000601:surgery*; D018709:Statistics, Nonparametric; D013536:Suture Techniques / Q000662:veterinary