Translaryngeal percutaneous arytenoid lateralization technique in a canine cadaveric study

To describe the technique for translaryngeal percutaneous arytenoid lateralization (TPAL) and the effect on rima glottidis cross-sectional area using a canine cadaveric model.

Ex vivo study.

Canine cadavers (n = 9).

With the aid of a laryngoscope, the larynx was visualized and a mattress suture (double-armed 2-0 polypropylene) was placed through the right arytenoid cartilage and exited the skin ventral to the jugular vein. The ends of the suture were passed through a button and tied on the skin to lateralize the right arytenoid cartilage. Digital images of the larynx were made before and after suture placement. Mean (±SD) rima glottidis cross-sectional area (mm(2) ) was calculated from the digital images and values before and after suture placement were compared using a paired t-test. A P value < 0.05 was considered significant. Change in cross-sectional area was expressed as percent increase.

Suture placement and the degree of arytenoid lateralization was relatively consistent in all dogs. Mean (±SD) cross-sectional area of the rima glottidis was 126.3 mm(2) (±7.74) before and 172.1 mm(2) (±24.7) after suture placement (P = 0.004). Mean percent increase in cross-sectional area was 25%.

The TPAL technique was effective at enlarging the rima glottidis in this canine cadaveric model. TPAL is rapid to perform and does not require specialized instrumentation. Results of this study support further investigation of the TPAL technique as an alternative to temporary tracheostomy for dogs in severe respiratory distress due to laryngeal paralysis.