title: Revision laryngeal framework surgery performed by directly pulling the lateral cricoarytenoid muscle.
abstract: BACKGROUND
  Revision laryngeal framework surgery is usually performed for medialisation laryngoplasty failure, rather than for failure after arytenoid adduction. We describe a new method for revision arytenoid adduction surgery, performed by directly pulling the lateral cricoarytenoid muscle ('lateral cricoarytenoid muscle pull surgery').
  
  
  METHODS
  We describe a case of revision laryngeal framework surgery, present a literature review and describe the advantages of lateral cricoarytenoid muscle pull surgery over the original method of arytenoid adduction using a posterior approach.
  
  
  RESULTS
  Medialisation laryngoplasty combined with arytenoid adduction was performed following unilateral vocal fold paralysis from mediastinal surgery, resulting in severe glottic insufficiency. The patient's voice improved after the initial surgery, but had deteriorated 18 months later. Revision surgery was performed using lateral cricoarytenoid muscle pull surgery, and her voice recovered normally in terms of perceptual impression. The post-operative course was uneventful for 10 months following revision surgery.
  
  
  CONCLUSIONS
  To our knowledge, this is the first case of revision arytenoid adduction performed using a lateral cricoarytenoid muscle pull approach. Lateral cricoarytenoid muscle pull surgery should therefore be considered as a new fenestration approach for arytenoid adduction.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery,Jichi Medical UniversitySchool of Medicine,Shimotsuke,Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kanazawa
authors.affiliation: Tokyo Voice Centre,International University of Health and Welfare,Tokyo,Japan.
authors.forename: D
authors.initials: D
authors.lastname: Komazawa
authors.affiliation: Tokyo Voice Centre,International University of Health and Welfare,Tokyo,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery,Jichi Medical UniversitySchool of Medicine,Shimotsuke,Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ichimura
mesh_terms: D000368:Aged; D001184:Articulation Disorders / Q000601:surgery; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000601:surgery*; D012086:Reoperation / Q000379:methods*; D012196:Review Literature as Topic; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*