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Arytenoid abduction for bilateral vocal fold immobility
1Southern Illinois University School of Medicine, Springfield, Illinois 62794-9662, USA. gwoodson@siumed.edu
Current Opinion in Otolaryngology & Head and Neck Surgery
|October 18, 2011
Summary
Arytenoid abduction surgery can improve airway function in patients with bilateral vocal fold paralysis by repositioning the arytenoid cartilage. This procedure offers a promising solution for selected individuals with neurogenic laryngeal paralysis.
Area of Science:
- Laryngology
- Surgical Innovation
- Vocal Fold Physiology
Background:
- Bilateral vocal fold immobility stems from mechanical fixation or neurogenic paralysis.
- Surgical arytenoid abduction is a treatment for bilateral neurogenic laryngeal paralysis.
Purpose of the Study:
- Review the theoretical basis of arytenoid abduction.
- Evaluate clinical outcomes of arytenoid abduction for laryngeal paralysis.
Main Methods:
- Review of existing literature on arytenoid abduction.
- Analysis of the pathophysiology of vocal fold immobility.
- Examination of cricoarytenoid joint mechanics.
Main Results:
- Arytenoid abduction leverages residual adductor muscle function and the multiaxial cricoarytenoid joint.
- The procedure aims to simulate posterior cricoarytenoid (PCA) muscle action.
- Improved airway reported in many patients; vocal function generally preserved.
- Less effective in cases with inspiratory adductor activity or prior glottic enlargement procedures.
Conclusions:
- Arytenoid abduction is a viable surgical option for specific patients.
- Successful outcomes depend on patient selection criteria.
- This procedure offers a promising treatment for bilateral neurogenic laryngeal paralysis.
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