Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-14T19:44:10.903Z Has data issue: false hasContentIssue false

Surgical histoanatomy for adduction arytenopexy using injection laryngoplasty

Published online by Cambridge University Press:  18 December 2018

K Sato*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kurume University School of Medicine, Japan
S Chitose
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kurume University School of Medicine, Japan
F Sato
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kurume University School of Medicine, Japan
H Umeno
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kurume University School of Medicine, Japan
*
Author for correspondence: Dr K Sato, Department of Otolaryngology – Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan E-mail: kimisato@oct-net.ne.jp Fax: +81 942 37 1200

Abstract

Background

In order to improve a large posterior glottal gap and/or aspiration, injections of augmentation substances should not only be administered at the mid-membranous vocal fold in the thyroarytenoid muscle, but also at the cartilaginous portion of the vocal fold to make adduction arytenopexy possible.

Method

Ten adult human larynges were investigated using the whole-organ serial section technique.

Results

Vertical thickness of the posterior aspect of the thyroarytenoid muscle was relatively thin (3.4 ± 0.4 mm), especially in females (3.2 ± 0.3 mm). Consequently, care should be taken to ensure the correct depth of needle placement. If the needle is placed too deep, augmentation substances are injected into the lateral cricoarytenoid muscle, located beneath the thyroarytenoid muscle, or into the paraglottic space, located inferolateral to the thyroarytenoid muscle.

Conclusion

The injection location and the amount of injected material should be modified based on the pathological conditions of the voice disorder and aspiration.

Type
Short Communications
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr K Sato takes responsibility for the integrity of the content of the paper

Presented at the 97th Annual Meeting of the American Broncho-Esophagological Association, 26–28 April 2017, San Diego, California, USA.

References

1Woo, P. Arytenoid adduction and medialization laryngoplasty. Otolaryngol Clin North Am 2000;33:817–40Google Scholar
2Laccourreye, O, Paczona, R, Ageel, M, Hans, S, Brasnu, D, Crevier-Buchman, L. Intracordal autologous fat injection for aspiration after recurrent laryngeal nerve paralysis. Eur Arch Otorhinolaryngol 1999;256:458–61Google Scholar
3Rosen, CA, Simpson, CB. Operative Techniques in Laryngology. Berlin: Springer-Verlag, 2008;209–13Google Scholar
4Von Leden, H, Moore, P. The mechanics of the cricoarytenoid joint. Arch Otolaryngol 1961;73:541–50Google Scholar
5Rubin, E, Farber, JL. Cell injury. In: Rubin, E, Farber, JL, eds. Pathology, 3rd edn. Philadelphia: Lippincott-Raven Publishers, 1999;135Google Scholar
6Sato, K. Histopathology of vocal fold atrophy. Jpn J Logop Phoniatr 2002;43:432–7Google Scholar
7Hirano, M. Phonosurgery. Basic and clinical investigations [in Japanese]. Otologia (Fukuoka) 1975;21(suppl 1):239440Google Scholar
8Hirano, M, Sato, K. Histological Color Atlas of the Human Larynx. San Diego: Singular Publishing Group, 1993Google Scholar
9Sato, K, Umeno, H, Nakashima, T. Liposuctioned autologous fat injection into the larynx and hypopharynx with aspiration after vagal nerve paralysis [in Japanese]. Nihon Kikan Shokudoka Gakkai Kaiho 2002;53:353–7Google Scholar
10Sato, K, Umeno, H, Nakashima, T. Injection laryngoplasty according to the pathologic condition [in Japanese]. Nihon Jibiinkoka Gakkai Kaiho 2003;106:808–14Google Scholar
11Sato, K, Umeno, H, Nakashima, T. Autologous fat injection laryngohypopharyngoplasty for aspiration after vocal fold paralysis. Ann Otol Rhinol Laryngol 2004;113:8792Google Scholar