Sling arytenoid adduction
Sling arytenoid adduction
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吊带杓状软骨内收
DOI：
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发表时间：
2011
影响因子：
2.6
通讯作者：
K. Püschel
中科院分区：
文献类型：
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作者：
M. Hess;Daniel M. Schroeder;K. Püschel
本研究的目的是描述一种简化的杓状软骨旋转技术，并测试其适用于切除的人喉。通过外部入路将不可吸收的单丝线悬挂在杓状软骨的肌突周围。在通过柔性内窥镜进行目视控制期间，仅需要两个针头和一个钢丝环针头穿线器。拉紧缝线并固定，可稳定杓状软骨内收。这种技术避免了环甲关节离断，并保留了完整的甲状软骨。在五个离体喉实验中证实了该技术的实用性。在两个临床病例中，用单丝线悬吊和牵拉肌突。平行于LCA肌肉的向量方向的张力显示了有效和稳定的杓状软骨旋转，后声门完全闭合。悬带杓状软骨内收术（SAA）后的旋转效果与传统杓状软骨内收术的结果相似。然而，SAA是从外部途径进行的，避免了软骨解剖。避免了为达到肌突而进行的交叉解剖。在某些单侧声带不动的病例中，可以使用SAA技术进行杓状软骨旋转，该技术允许外部和喉外入路。进一步的研究应该评估这项技术的临床价值。原则上，线环针穿线器也可用于外部声带定侧手术。
The purpose of this study was to describe a simplified arytenoid rotation technique and to test its applicability in excised human larynges. A non-absorbable monofilament thread is slung around the muscular process of the arytenoid cartilage through an external approach. During visual control through flexible endoscopy, two needles and a wire loop needle threader are the only instruments needed. Thread tensioning and fixation results in a stabilized arytenoid adduction. This technique avoids cricothyroid joint disarticulation and leaves the thyroid cartilage intact. The practicability of the technique was proven in five excised larynx experiments. In two clinical cases, the muscular process was slung and pulled with a monofilament thread. Tension in the vector direction parallel to the LCA muscle showed an effective and stable arytenoid rotation with complete closure of the posterior glottis. The rotational effect following sling arytenoid adduction (SAA) is similar to conventional arytenoid adduction surgery outcome. However, SAA is performed from an external approach and avoids dissection of cartilage. Challenging dissections to reach the muscular process are avoided. In some cases of unilateral vocal fold immobility, arytenoid rotation may be performed by using the SAA technique, which allows for an external and extralaryngeal approach. Further studies should assess the clinical value of this technique. In principal, the wire loop needle threader can also be employed for external vocal fold lateralization procedures.