Arytenoid adduction combined with nerve‐muscle pedicle flap implantation or type I thyroplasty

Kodama, Narihiro; Kumai, Yoshihiko; Sanuki, Tetsuji; Yumoto, Eiji

doi:10.1002/lary.26032

Cited by 12 publications

(2 citation statements)

References 31 publications

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“…Although there was no significant difference, jitter in Group 1 was nearly half that of Group 3. In addition, as reported by Kodama et al 14,15 MPT, jitter and VHI-10 after AA combined with NMP flap transfer continued to improve over the course of 2 years postoperatively. Therefore, vocal function after AA without separation of the CT joint might continue to improve over a 2-year period.…”

Section: Discussionsupporting

confidence: 73%

Modified Isshiki’s arytenoid adduction without separating cricothyroid and cricoarytenoid joints

Yumoto

Sanuki

Kumai

et al. 2020

Acta Otorhinolaryngol Ital

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Modified methods of arytenoid adduction (AA) have been reported to keep the cricothyroid (CT) joint intact. However, postoperative laryngeal oedema and long-term vocal function have not been compared with those after AA with CT joint separation. We refined AA to combine it with nerve-muscle pedicle (NMP) flap transfer for preservation of the CT joint. Eight patients with unilateral laryngeal paralysis underwent the procedure (Group 1). Postoperative oedema at membranous vocal fold (MVF), arytenoid mound (AM) and pyriform sinus (PS) was assessed using a 4-point ordinal scale: none (0) to severe (3). Laryngeal oedema in Group 1 was compared with that of 19 patients who had AA with CT joint separation (Group 2). Maximum phonation time (MPT), jitter and voice handicap index-10 (VHI-10) were measured before surgery and one year postoperatively. Vocal function in Group 1 was compared with 58 patients who underwent AA + NMP flap transfer with CT joint separation (Group 3). The degree of oedema from postoperative days 1 to 6 in Group 1 was relatively invariable: 1.

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Section: Discussionsupporting

confidence: 73%

Modified Isshiki’s arytenoid adduction without separating cricothyroid and cricoarytenoid joints

Yumoto

Sanuki

Kumai

et al. 2020

Acta Otorhinolaryngol Ital

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“…Some methods for RLN reconstruction have been reported, including direct RLN anastomosis [ 14 , 15 ], graft interposition between the dissected edges of the RLN [ 16 ], and ansa cervicalis nerve (ACN) to RLN anastomosis [ 17 , 18 ]. When RLN reconstruction is difficult, phonosurgeries, such as thyroplasty type I [ 19 , 20 ], arytenoid adduction (AA) [ 21 ], VF injection augmentation [ 22 ], or nerve muscle pedicle (NMP) transplantation [ 23 , 24 , 25 , 26 , 27 , 28 ], should be considered. NMP transplantation is a method to induce reinnervation of the laryngeal muscle with implantation of other muscle nerve branches to the laryngeal muscle directly.…”

Section: Introductionmentioning

confidence: 99%

Optimal Management of the Unilateral Recurrent Laryngeal Nerve Involvement in Patients with Thyroid Cancer

Miyamaru

Murakami

Nishimoto

et al. 2021

Cancers

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We aimed to determine the optimal management of recurrent laryngeal nerve (RLN) involvement in thyroid cancer. We enrolled 80 patients with unilateral RLN involvement in thyroid cancer between 2000 and 2016. Eleven patients with preoperatively functional vocal folds (VFs) underwent sharp tumor resection to preserve the RLN (shaving group). Thirty-three patients underwent RLN reconstruction with RLN resection (reconstruction group). We divided the reconstruction group into two subgroups based on preoperative VF mobility (normal-reconstruction and paralyzed-reconstruction subgroups). In the cases where RLN reconstruction was difficult, phonosurgeries including arytenoid adduction (AA), with or without thyroplasty type I, or nerve muscle pedicle implantation with AA were performed later (phonosurgery group). We evaluated and compared vocal function among the evaluated periods and different groups. Postoperative vocal function in the shaving and normal-reconstruction subgroups was favorable. There were no significant differences between the two groups. In the paralyzed-reconstruction and phonosurgery groups, postoperative vocal function was significantly improved, and vocal function in the paralyzed-reconstruction subgroup was significantly better than that in the phonosurgery group. For optimal management of unilateral RLN involvement in thyroid cancer, first, sharp dissection should be performed, and if this is impossible, a simultaneous RLN reconstruction procedure should be adopted whenever possible.

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Therapie von Rekurrensparesen

Müller

2017

HNO

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Whereas static vocal fold medialization or lateralization are currently the standard procedures, new dynamic treatment methods such as reinnervation and laryngeal pacing focus on better toning and remobilization of the paralyzed vocal folds. End-to-end or jump anastomoses of the recurrent laryngeal nerve can preserve muscle mass and avoid atrophy, thus enabling subsequent dynamic therapeutic options. Prognostic evaluation and the time point of therapeutic intervention are important issues in the management of patients with recurrent laryngeal nerve paralysis. Irreversible interventions should be avoided at early time points or during childhood in order to allow for spontaneous remission and dynamic therapeutic options.

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Arytenoid adduction combined with nerve‐muscle pedicle flap implantation or type I thyroplasty

Abstract: 4. Laryngoscope, 127:159-166, 2017.

Cited by 12 publications

References 31 publications

Modified Isshiki’s arytenoid adduction without separating cricothyroid and cricoarytenoid joints

Modified Isshiki’s arytenoid adduction without separating cricothyroid and cricoarytenoid joints

Optimal Management of the Unilateral Recurrent Laryngeal Nerve Involvement in Patients with Thyroid Cancer

Therapie von Rekurrensparesen

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