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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

Clinical experience with Gray's minithyrotomy procedure.

Randal C Paniello¹, Lucian Sulica, Siddarth M Khosla

¹Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri 63110, USA.

The Annals of Otology, Rhinology, and Laryngology

|July 24, 2008

Summary

Gray's minithyrotomy offers an effective surgical approach for vocal fold scarring and bowing. This technique allows precise fat implantation, improving mucosal pliability and glottal closure for better voice quality.

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Area of Science:

Otolaryngology
Laryngeal Surgery
Voice Restoration

Background:

Endoscopic vocal fold surgery has limitations in scar release and precise filler material implantation.
The minithyrotomy approach, described by Gray et al. in 1999, offers an alternative for submucosal vocal fold procedures.

Purpose of the Study:

To review the technical aspects, clinical indications, and early outcomes of the minithyrotomy approach for vocal fold surgery.
To evaluate the efficacy of minithyrotomy in addressing various vocal fold pathologies.

Main Methods:

Retrospective review of patient records, clinical notes, and videostroboscopic examinations.
Analysis of data from patients who underwent the minithyrotomy procedure performed by the four authors.

Main Results:

Twenty-two minithyrotomy procedures were performed on 21 patients for conditions including vocal fold scarring, radiation fibrosis, sulcus vocalis, and bowing.
Autologous fat was implanted in 20 patients, leading to improved mucosal pliability (19 cases) and glottal closure (20 cases).
Most patients reported voice improvement with minimal complications.

Conclusions:

Gray's minithyrotomy is a highly effective surgical technique for vocal fold scar processes, bowing, and sulcus vocalis.
The procedure facilitates precise submucosal intervention and autologous fat implantation, enhancing vocal fold function.