Table of Contents
What is adduction Arytenopexy?
Adduction arytenopexy with cricothyroid subluxation affords a reliable method of surgical repositioning of the paralyzed vocal fold. By replicating the medial and posterior vector forces applied to the arytenoid during phonation, the membranous vocal fold is returned to its proper height, medial position and length.
What is Medialization thyroplasty?
Medialization laryngoplasty (formerly known as thyroplasty) is a surgical treatment for vocal cord paralysis. Your surgeon places an implant into your paralyzed or weak vocal cord. The implant moves a nonfunctioning vocal cord toward the functioning one to allow for better voicing.
Can you remove Arytenoids?
Arytenoid cartilage is removed totally with the aid of conventional cold steel instruments. Care must be utilized not to damage cricoid cartilage; otherwise subglottic stenosis may ensue. During dissection of arytenoid, mucosa medial to arytenoid is carefully preserved to be later used as an advancement flap.
What causes abduction of vocal cords?
This loss of abduction is due to simultaneous contraction of the adductor and abductor muscles during inspiration. After selective section of the adductor nerve branches within the larynx, the vocal cord abducts with each inspiration. Abduction is strongest during hyperpnea or airway obstruction below the larynx.
What is arytenoid subluxation?
Arytenoid subluxation or dislocation is a rare laryngeal injury that occurs as a result of airway instrumentation or direct trauma to the cricoarytenoid joint, leading to the partial (subluxation) or total (dislocation) displacement of the arytenoid cartilage within the cricoarytenoid joint.
What causes adduction of vocal cords?
Contraction of the thyroarytenoid, interarytenoid, and lateral cricoarytenoid muscles causes adduction of the vocal cords. The respiratory movements of the vocal cords are coordinated with those of the diaphragm and other muscles of the ventilator pump.
What happens when vocal cords are abducted?
Abduction: The vocal folds abduct (come apart) in order to let air in and out of the lungs during breathing. Adduction: The vocal folds may adduct (come together) to trap air in the lungs. They may also adduct to vibrate to produce vocal sound.
Why is a thyroplasty performed?
Thyroplasty is a procedure performed to change the position of the vocal cord. This is usually performed to improve a patient’s voice and ability to cough. Thyroplasty is performed in the operating room with the patient asleep during parts of the surgery.
What is vocal fold Medialization?
VOCAL FOLD MEDIALIZATION. The type of treatment that has become most popular for treatment of unilateral vocal fold immobility is known as vocal fold medialization. This is an operation in which a small implant of some material is surgically implanted inside the larynx to move the immobile fold closer to the midline.
What muscle abducts the vocal cords?
posterior cricoarytenoid
Internal musculature is the primary group of muscles involved in phonation by either abducting or adducting the vocal folds. The sole abductor of the group is the posterior cricoarytenoid. The muscles, lateral cricoarytenoid, thyroarytenoid, interarytenoid, and cricothyroid, all act together to adduct the vocal folds.
What is arytenoid adduction?
Arytenoid adduction is a surgical procedure used to treat vocal cord paralysis. A suture is used to emulate the action of the lateral cricoarytenoid muscle and position the paralyzed vocal cord closer to the midline.
Is arytenoid adduction more difficult than medialization thyroplasty?
Arytenoid adduction is more technically challenging than either vocal cord injection or medialization thyroplasty and has a high learning curve. Increased incidence of complications have been reported for arytenoid adduction compared to medialization thyroplasty.
Does arytenoid adduction improve quality of life in vocal cord paralysis?
Arytenoid adduction with or without medialization thyroplasty significantly improves quality of life for patients with vocal cord paralysis. Subjective outcome measures of voice quality include the Grade, Roughness, Breathiness, Asthenia, Strain (GBRAS) voice scale, Voice Handicap Index, and closure of the glottic gap.
What is a arytenoid suture used for?
A suture is used to emulate the action of the lateral cricoarytenoid muscle and position the paralyzed vocal cordcloser to the midline. This allows the two vocal cords to meet and can improve speaking and swallowing ability for affected patients. Arytenoid adduction is often performed in conjunction with medialization thyroplasty.