A new thread guide instrument for endoscopic arytenoid lateropexy

Area of Science:

• Otolaryngology
• Minimally Invasive Surgery
• Vocal Cord Function Restoration

Background:

• Bilateral vocal cord immobility (BVCI) presents diverse etiologies necessitating varied surgical interventions.
• Existing surgical approaches for BVCI can be complex and invasive.

Purpose of the Study:

• To introduce and evaluate a novel endolaryngeal thread guide instrument (ETGI) for minimally invasive endoscopic arytenoid lateropexy.
• To assess the efficacy of ETGI-assisted lateropexy in treating various causes of BVCI.

Main Methods:

• Prospective study involving patients with bilateral vocal cord paralysis, mechanical fixations, posterior glottic stenoses, and rheumatoid ankyloses.
• Utilized the ETGI for endoscopic arytenoid lateropexy, involving thread guidance for arytenoid cartilage abduction.
• Cricoarytenoid joint mobilization with cold knife and CO2 laser was performed for fixation cases.

Main Results:

• Improved breathing ability was confirmed by spirometry in 32 patients.
• Subjective voice improvement was noted in 12 patients; 16 experienced incomplete recovery.
• One temporary tracheostomy was required; one patient undergoing radiotherapy could not be decannulated.

Conclusions:

• Endoscopic arytenoid lateropexy using the ETGI is an effective and minimally invasive treatment for BVCI of varied etiologies.
• The ETGI facilitates rapid and safe creation of fixating loops, simplifying the lateropexy procedure.
• This technique offers a promising solution for improving respiratory and phonatory function in BVCI patients.