Sling arytenoid adduction.

Area of Science:

• Otolaryngology
• Laryngeal Surgery
• Vocal Fold Dynamics

Background:

• Conventional arytenoid adduction surgery can be invasive, requiring dissection and potentially impacting laryngeal structures.
• Unilateral vocal fold immobility necessitates effective surgical solutions for glottic closure.

Observation:

• A simplified arytenoid rotation technique (SAA) utilizes a monofilament thread passed externally around the arytenoid cartilage's muscular process.
• The procedure requires minimal instrumentation, including flexible endoscopy, needles, and a wire loop needle threader.
• Tensioning the thread stabilizes the arytenoid, achieving adduction and vocal fold closure.

Findings:

• The SAA technique successfully demonstrated stable arytenoid rotation and complete posterior glottis closure in excised human larynges.
• Clinical application in two cases confirmed the effectiveness of SAA, achieving outcomes similar to conventional methods.
• This external approach avoids cricothyroid joint disarticulation and thyroid cartilage dissection.

Implications:

• SAA presents a less invasive alternative for arytenoid adduction, potentially beneficial for patients with unilateral vocal fold immobility.
• The technique's external and extralaryngeal approach simplifies the procedure and reduces surgical risks.
• Further research is warranted to fully establish the clinical value and long-term efficacy of SAA.