Cricoarytenoid Joint Ankylosis: Classification and Transoral Laser Microsurgical Treatment

Atallah, I.; Manjunath, MK; Omari, Ahmad Al; Righini, Christian; Castellanos, Paul F.

doi:10.1016/j.jvoice.2017.11.020

Cited by 21 publications

(29 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If the right combination of techniques is applied, the number of procedures necessary could be minimized. Atalah et al 8 devised a modified Bogdasarian scale with the subdivisions of grade 3 and 4 into IIA, IIIb, IVa, and IVb, to indicate severity of joint fixation. They noted that the number of surgeries required per patient decreased as they progressed through their study, which was presumably due to more aggressive dissection of the arytenoids when indicated by their classification system.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Posterior Glottic Stenosis Surgery Outcomes: Systematic Review and Meta-analysis

Kremer

Jiang

Singh

et al. 2021

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objectives: To investigate surgical adjuncts (stents) and previous surgeries on outcomes from posterior glottic stenosis (PGS). Methods: PubMED/Medline, CINAHL, EMBASE, and Web of Science were searched for publications on adult patients undergoing surgery for PGS. Decannulation and need for additional surgeries were evaluated as outcomes. Linear mixed-effects (with random effects and fixed effects) models were used for multivariate testing. Results: In total, 516 abstracts were reviewed and 26 articles were considered for systematic review. Of these, 19 articles with 140 pooled patient cases were extracted for meta-analysis. On multivariate meta-analysis analysis accounting for study-specific variation and use of open procedures, prior surgeries were associated with additional surgeries (RR = 3.76 [1.39-3.86], P = .038) and the use of a stent was associated with a lower likelihood of decannulation (RR = 0.42 [0.09-0.98], P = .044). Conclusion: Minimizing repeat surgery is a predictor for avoiding additional future surgeries and use of a stent was correlated with poor outcomes. These 2 findings may assist providers in patient counseling regarding the need for further surgical interventions. Further, this study is the first to compare the efficacy of surgical approaches for the resolution of PGS, and highlights the importance of avoiding repeat procedures and stents for the management of PGS.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors Affecting Posterior Glottic Stenosis Surgery Outcomes: Systematic Review and Meta-analysis

Kremer

Jiang

Singh

et al. 2021

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

show abstract

“…20,21 We previously described multiple techniques of reconstructive TLM which we termed "reconstructive transoral laser microsurgery" (R-TLM). 10,[22][23][24][25][26][27] The most significant difference between TLM and R-TLM is that in R-TLM, laryngeal anatomy and physiology are preserved as much as possible. This is made possible by techniques of R-TLM that helps tissue dissection with microinstruments and CO 2 laser with minimal trauma and to raise mucosal flaps.…”

Section: Discussionmentioning

confidence: 99%

“…Since 2010, TLM has made possible functional surgery in nonneoplastic diseases of the pharynx and larynx using CO 2 laser tissue resection without any endoscopic repair or suturing 20,21 . We previously described multiple techniques of reconstructive TLM which we termed “reconstructive transoral laser microsurgery” (R‐TLM) 10,22‐27 . The most significant difference between TLM and R‐TLM is that in R‐TLM, laryngeal anatomy and physiology are preserved as much as possible.…”

Section: Discussionmentioning

confidence: 99%

Transoral closure of the supraglottic larynx for intractable aspiration

Atallah

Castellanos

2020

Head & Neck

Self Cite

View full text Add to dashboard Cite

The aim of this paper is to describe a novel, safe, and effective surgical technique to eliminate aspiration, that is performed entirely by reconstructive transoral laser microsurgery (R-TLM). Eleven tracheostomy-dependent patients with recurrent pneumonia secondary to intractable aspiration treated with transoral laryngeal closure were included in our study. In all cases, the supraglottic mucosa is incised in a circumferential manner. The distal tissues are sutured side-to-side longitudinally, and the superficial tissues are sutured back-to-front transversally. All patients successfully underwent transoral laryngeal closure without significant perioperative complication. Four patients resumed oral feeding for effective nutrition and two patients for pleasure. One patient developed a small fistula with a leak that warranted secondary closure by a follow-up R-TLM procedure and subsequently held to protect his airway. Complete supraglottic laryngeal closure can be performed safely and effectively using R-TLM techniques. They provide a natural-orifice alternative to open surgery in patients with intractable aspiration.

show abstract

“…To avoid wound infections, we do copious saline irrigation during surgery, especially before wound closure. Moreover, the surgical wound (supraglottic laryngotomy) is always meticulously and tightly closed using our endoscopic suture technique, which has been described in our previous works …”

Section: Discussionmentioning

confidence: 99%

“…At the end of the surgery, jet ventilation is stopped and an endotracheal tube is placed for wake up from anesthesia. The details of the R‐TLM techniques used in this operation can be found in prior papers of ours …”

Section: Methodsmentioning

confidence: 99%

Transoral silastic medialization for unilateral vocal fold paralysis

2019

Self Cite

View full text Add to dashboard Cite

Background Medialization laryngoplasty has historically been performed through an external approach. The aim of our work is to demonstrate the feasibility of silastic vocal fold medialization transorally. Methods Patients with unilateral vocal fold paralysis requiring medialization laryngoplasty were included in this report. Silastic medialization was done through a transoral approach. A supraglottic laryngotomy is performed followed by dissection and tunneling in the paraglottic space. Silastic implant is inserted into the tunnel to medialize the vocal fold and the ipsilateral arytenoid. The laryngotomy is tightly closed by endoscopic sutures. Results A consecutive series of 22 patients are reported. All patients had dysphonia with significant glottic insufficiency. After endoscopic silastic medialization, voice and swallowing were significantly improved (P < .001). No postoperative complications or implant extrusion occurred in our series. Conclusion Silastic vocal fold medialization can be safely and effectively performed through a transoral approach with good results on voice and swallowing.

show abstract

Cricoarytenoid Joint Ankylosis: Classification and Transoral Laser Microsurgical Treatment

Cited by 21 publications

References 15 publications

Factors Affecting Posterior Glottic Stenosis Surgery Outcomes: Systematic Review and Meta-analysis

Factors Affecting Posterior Glottic Stenosis Surgery Outcomes: Systematic Review and Meta-analysis

Transoral closure of the supraglottic larynx for intractable aspiration

Transoral silastic medialization for unilateral vocal fold paralysis

Contact Info

Product

Resources

About