Endo‐Extralaryngeal Needle Carrier Instrument

Abstract

The author reports on an instrument which is suitable for stitching from inside to outside under laryngomicroscopic control without opening the larynx. The instrument, as well as the operation techniques based on the instrument, permit the simple treatment of vocal cord synechiae and of laryngostenosis consequent to bilateral paralysis of the recurrent laryngeal nerve.

"Early" vocal cord laterofixation for the treatment of bilateral vocal cord immobility

“…The endo-extralaryngeal suture technique was first described by Lichtenberger [10] for laryngeal stenosis. We modified the original method in some aspects to make it more reliable for the concept of "early" laterofixation.…”

“…We have extended the indication to all types of bilateral VCI within 6 months from the paralysis, so we called the procedure an "early" (temporary) lateralization of the vocal cord [7]. Additionally, an endoscopic endo-extralaryngeal suture technique -a modification of Lichtenberger's "A" technique [10,11] -was used instead of Ejnell's exo-endolaryngeal technique [4]. Theoretically, the primary treatment concept must satisfy two important criteria in the critical early period of bilateral VCI:…”

Intraluminäre Verfahren der Glottiserweiterung bei bilateraler Stimmlippenparese

“…Ein entscheidender Fortschritt war die Einführung der endoextralaryngealen Lateralfixation nach Lichtenberger [16,17,18] mithilfe eines speziellen Nadelhalters, mit welchem in Hochfrequenz-Jet-Anäs-thesie oder während Apnoephasen nach vorheriger Präoxygenierung translaryngeal zwei monofile, nichtresorbierbare Fäden (z. B. Prolene® 2-0 oder 0) exakt positioniert werden können.…”

Combined use of endoscopic CO 2 laser excision of a marginal laryngeal tumor, radical neck dissection, and perioperative laterofixation of the opposite vocal cord

“…Two endo-extralaryngeal sutures were inserted endoscopically with the Lichtenberger [8] needle carrier to the posterior-third of the left vocal cord and tied under the skin and over the prelaryngeal muscle. Postoperatively, the glottis width was shown to be 3.5 mm and to provide a sufficient airway without tracheostomy (FIV 1 = 2.25 l).…”

“…Lichtenberger [8] reported a helpful technique for widening the glottis in which the vocal cord can be sutured with an endo-extralaryngeal needle carrier and pulled laterally. This method also provides a steady laterofixation of the vocal cord and a better airway for the patient that can be checked by spirometry [6,7].…”