Minimally invasive unilateral arytenoid lateralization in dogs: A cadaveric study

Shipov, Anna; Israeli, Inbar; Weiser, M.; Kelmer, Efrat; Klainbart, Sigal; Milgram, Joshua

doi:10.1016/j.rvsc.2015.07.019

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…In previous studies performed in the dog, a number of storage strategies for ex vivo larynges have been described. These include the use of: fresh harvested larynges; 23 fresh larynges that were stored in saline-soaked swabs at 2°C for 24 h 29 or up to a week before the study; 22 larynges fixed in 2-phenoxyethanol 2%, wrapped in saline-soaked swabs and stored at 4°C for up to 2 weeks before the study; 19 , 20 larynges harvested after storing the complete cadaver at 5°C for up to 48 h before the study; 30 or larynges stored at −20°C for use within 1 day after thawing. 21 Although not studied specifically, Guillemot et al suggested that fixing ex vivo larynges with 2-phenoxyethanol 2% prior to storage preserved soft tissue properties while maintaining the mobility of the arytenoid cartilages.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of two unilateral laryngoplasty techniques and their effect on arytenoid cartilage abduction in cats

Bonanno¹,

White

2023

Journal of Feline Medicine and Surgery

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Objectives The aim of this study was to evaluate two unilateral laryngoplasty (arytenoid lateralisation) techniques for use in the surgical management of laryngeal paralysis in cats. Methods Left cricoarytenoid abduction (lateralisation) was performed in 20 ex vivo cat larynges; 10 following complete cricoarytenoid disarticulation (group LAA-dis) and 10 following no cricoarytenoid disarticulation (group LAA-nodis). For both groups, left arytenoid abduction (LAA) was measured in the resting and postoperative larynges using image analysis software. Measurements were evaluated using the Mann–Whitney U-test. For both groups, dorsal images of the postoperative larynges were assessed visually for evidence of epiglottic coverage of the entrance to the larynx. Results The mean percentage increase in LAA was 311.5% and 199.4% ( P <0.006) for group LAA-dis (complete cricoarytenoid disarticulation) and group LAA-nodis (no cricoarytenoid disarticulation), respectively. In both groups, there was no evidence of a lack of epiglottic coverage of the entrance of the larynx for any of the postoperative larynges. Conclusions and relevance Placement of a single, tensioned suture between the muscular process of the left arytenoid cartilage and the caudolateral aspect of the ipsilateral cricoid cartilage (unilateral cricoarytenoid lateralisation) resulted in abduction of the left arytenoid cartilage and a corresponding increase in the area of the rima glottidis on the operated side. The clinical significance of the difference in outcome between left cricoarytenoid abduction following complete cricoarytenoid disarticulation and abduction following no cricoarytenoid disarticulation remains unclear, and both might be considered appropriate for the surgical management of laryngeal paralysis in the cat.

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Section: Discussionmentioning

confidence: 99%

Evaluation of two unilateral laryngoplasty techniques and their effect on arytenoid cartilage abduction in cats

Bonanno¹,

White

2023

Journal of Feline Medicine and Surgery

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“…The TPAL technique described in this study differs slightly from the technique described by Shipov et al (2015). Firstly, the sutures were placed via an oral approach rather than from the external surface of the neck.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, three techniques for percutaneous arytenoid lateralization have been described in a canine cadaver model as minimally-invasive options for management of dogs with laryngeal paralysis (Hardie, 2016; Shipov et al, 2015; Stegen et al, 2015). These techniques are intended as a less-invasive alternative to conventional surgical procedures or as an alternative to temporary tracheostomy for dogs at risk of repeated airway obstruction during transportation to a referral center, or for dogs requiring extended stabilization or additional diagnostic procedures prior to definitive surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

“…The free ends of the suture are either passed through a button and tied on the surface of the neck or tied on the lateral surface of the thyroid cartilage via a mini surgical approach, lateralizing the arytenoid cartilage. Both techniques are relatively easy to perform and proved effective at enlarging the rima glottidis in a cadaver model (Hardie, 2016; Shipov et al, 2015). However, further investigation in an experimental model is warranted before clinical application.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Translaryngeal Percutaneous Arytenoid Lateralization (TPAL) in dogs with experimentally created laryngeal paralysis

Sample

Hardie

Stein

et al. 2018

Research in Veterinary Science

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The aim of this experimental study was to evaluate the effect of Translaryngeal Percutaneous Arytenoid Lateralization (TPAL) in dogs with experimentally created laryngeal paralysis. All dogs (n = 5) underwent bilateral recurrent laryngeal neurectomy before TPAL. Two TPAL suture techniques were evaluated. TPAL-CranialCaudal (TPAL-CC) was performed first, followed 11 to 14 days later by TPAL-DorsalVentral (TPAL-DV). For both techniques, a mattress suture was placed through the arytenoid cartilage via an oral approach. Laryngeal examination was performed before, immediately after, and on days 1, 3 and 7 for both TPAL techniques. Ipsilateral hemiglottic surface area and the degree of laryngeal swelling or reaction to the suture were recorded. Laryngeal tissue was evaluated by histopathology at the end of the study. For both TPAL techniques, hemiglottic surface area was increased immediately after suture placement (P < 0.05). At all other times, hemiglottic area was not statistically different from preoperative value (P > 0.05). TPAL-DV resulted in less laryngeal swelling compared to TPAL-CC. Histopathology of the arytenoid cartilage surrounding the mattress suture revealed mucosal ulceration and inflammation consistent with the presence of the suture material. Both TPAL techniques were effective at lateralizing the arytenoid cartilage and significantly increasing hemiglottic surface area immediately after suture placement. However, mucosal swelling and loss of tension on the mattress suture lead to a decrease in glottic area within 24 h. Further refinements in suture placement technique are warranted to minimize swelling and improve the duration of arytenoid lateralization prior to clinical application.

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“…6,7 Additionally, the outcomes tend to be favorable compared to other more invasive and permanent techniques. [8][9][10] Although minimally invasive suture lateralization has been described previously, endoscopic manipulation with forceps technically is difficult.…”

Section: Discussionmentioning

confidence: 99%

The lasso technique for endoscopic suture lateralization in bilateral vocal fold immobility

et al. 2017

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Minimally invasive unilateral arytenoid lateralization in dogs: A cadaveric study

Cited by 3 publications

References 17 publications

Evaluation of two unilateral laryngoplasty techniques and their effect on arytenoid cartilage abduction in cats

Evaluation of two unilateral laryngoplasty techniques and their effect on arytenoid cartilage abduction in cats

Evaluation of Translaryngeal Percutaneous Arytenoid Lateralization (TPAL) in dogs with experimentally created laryngeal paralysis

The lasso technique for endoscopic suture lateralization in bilateral vocal fold immobility

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