• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.2
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• pp.126-130
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• 2009

Arytenoid motion has long been recognized as complex. Misunderstandings about the specifics of arytenoid motion remain prevalent. The resultant misunderstandings have led to erroneous or suboptimal clinical approaches to the treatment of vocal fold immobility. A thorough understanding of the anatomy of the arytenoid and cricoid cartilages, the cricoarytenoid joint, and related ligaments, muscles, and other structures is essential in order to fully understand laryngeal motion disorders. Arytenoid motion occurs in three directions. Movements involving a change anteriorly and posteriorly, as well as vertically, are due to the revolving or pitchlike motion of the arytenoid along the minor axis of the cricoid's elliptically shaped facet. The medial and lateral movements are due to the orientation of the arytenoid which in turn is determined by the forward, lateral, and inferior inclination of the cricoid-arytenoid facet. During adduction it is the outward angulation of the vocal process from the body of the arytenoid that allows the entire length of the vocal proceses to approximate one another and to have this meeting occur at the proper vertical height.

• Korean Journal of Bronchoesophagology
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• v.17 no.2
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• pp.112-115
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• 2011

Several reports have investigated airway obstruction caused by redundancy of arytenoid mucosa. Flexible laryngoscope examination revealed prolapse of the mucosa overlying the arytenoid. Usually, pharyngeal or laryngeal microscopic procedures can successfully treat the redundancy of arytenoid mucosa. We experienced two cases of airway obstruction caused by redundancy of artenoid mucosa and report it with review of literatures.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.6 no.1
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• pp.39-42
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• 1995

Surgical treatment options of symptomatic unilateral vocal fold paralysis are Teflon injection, type Ⅰ thyroplasty, and arytenoid adduction. Arytenoid adduction is preferable to type Ⅰ thyroplasty for correcting the level different that may be present between two vocal folds and the large glottal chink However there is no known therapeutic modality effective to correct the large posterior glottal chink of the vocal fold with relatively normal mobility. Recently we have experienced a case of severe large posterior glottal chink of the vocal 1314s with relatively normal mobility after thyroid lobectomy, successfully treated with type Ⅰ thyroplasty combined with arytenoid adduction.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.7 no.1
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• pp.5-10
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• 1996

From October 1991 to June 1995, 4 medialization thyroplasties and I arytenoid adduction were simultaneously performed with the thyroid surgery when the unilateral recurrent laryngeal nerve was paralyzed before or during thyroidectomy. Four cases were papillary carcinoma with direct invasion to the unilateral recurrent laryngeal nerve, and one case was huge adenomatous goiter and the recurrent laryngeal nerve was incidentaly cut. Hoarseness was present preoperatively with mean duration of 15 months and aspiration was also present in three cases. After phonosurgery, voice was improved in 4 out of 5 cases and aspiration subsided in 2 out of 3 cases. In one case, hoarseness continued after total thyroidectomy and thyroplasty type I and the arytenoid adduction with planned due to posterior glottic gap of 2mm. We suggest that the thyroplasty type I or arytenoid adduction are primary phonosurgical procedures which ran be performed concomitantly with neck surgeries in the patients with paralysis of the unilateral recurrent laryngeal or vagus nerve damage during neck surgeries.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.66-70
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• 1998

Background and Objectives : The managements of unilateral vocal cord palsy include type Ⅰ thyroplasty and arytenoid adduction. One type operation has been shown no satisfactory effect. We evaluated preoperative and postoperative speech of unilateral vocal cord palsy patients who received combined operation of type Ⅰ thyroplasty and arytenoid adduction to help for the management plan of unilateral vocal cord palsy patients. Materials and Methods : We reviewed the postoperative results and complication of 17 surgically treated patients of unilateral vocal cord palsy at Severance hospital from Nov. 1996 to Dec. 1997 retrospectively. They were received combined operation of type Ⅰ thyroplasty and arytenoid adduction. Their pre and post-operative speech were analyzed with MDVP(Multi-Dimension-Voice analysis Program) of CSL(Computerized Speech Lab). Results : After the operation, MPT(Maximal Phonation Time) was increased and MFR(Mean Flow Rate) was decreased in all patients. NHR(Noise to Harmonic Ratio) and VTI(Voice Turbulence Index) were decreased : liner, RAP(Relative Average Perturbation Quotient), PPQ(Pitch Period Perturbation Quotient), sPPQ(smoothed Pitch Period Perturbation Quotient), vFo(fundamental frequency Variation) were decreased : Shimmer, APQ(Amplitude Perturbation Quotient), sAPQ(Smoothed Amplitude Perturbation Qoutient), vAm(Peak Amplitude Variation) were decreased in all the patients. Conclusions : In unilateral vocal cord pals), combined operation of type Ⅰ thyroplasty and arytenoid adduction could obtain satisfactory postoperative voice. MDVP has many parameters and good method for evaluation of voice surgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.90-95
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• 2014

Background and Objectives : Arytenoid adduction procedure is one of the main surgical options addressed for the correction of glottal incompetence in patients with unilateral vocal cord paralysis. Traditionally, a midline approach is used for identifying and suturing around the muscular process, which often needs over-traction of the thyroid cartilage and results in patient's discomfort as well as surgeon's distress. The authors investigated the advantage of a modified procedure, lateral approach, in which the arytenoid cartilage is exposed through the space between strap muscles and sternocleidomastoid muscle. Materials and Methods : Retrospective chart review was performed for 66 patients who received arytenoid adduction surgery at Samsung Medical Center, between the year 1997 and 2014. Operation time, types of anesthesia, voice outcomes and complications were compared between the midline (n=22) and the lateral (n=44) approach group. Results : Operation time was shorter in the lateral approach group ($125{\pm}24min$) than in the midline group ($144{\pm}24min$). Arytenoid adduction was proceeded under local anesthesia in 66% (n=29/44) and 14% (n=3/22) of patients with lateral and midline approach group, respectively. Voice outcomes and complication rates were comparable between the two groups. Injection laryngoplasty in conjunction with arytenoid adduction resulted in more favorable voice outcomes. Conclusion : A lateral approach for the arytenoid adduction procedure showed comparable voice outcomes and similar complication rates with those of a midline approach. However, lateral approach provided less discomfort to the patients and less distress to a surgeon, and therefore, shorter operation time was needed and local anesthesia could be more frequently applied for this modified procedure.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.54-57
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• 2015

Hemangioma is one of the most common benign neoplasm, which occurs about 50% in head and neck region, but laryngeal hemangioma is relatively rare. Hemangioma occurred in larynx can be treated by surgical removal, cryosurgery, and steroid injection. Transoral CO2 laser micorsurgery has been known as useful method for the treatment of laryngeal hemangioma. We have experienced a 54-years old male patient of hemangioma originated in arytenoid area. This mass was removed via transoral approach with 'en bloc' resection by CO2 laser. We report this case regarding the treatment and prognosis of laryngeal hemangioma with review of literatures.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.74-74
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• 1993

Unilateral vocal cord paralysis is induced by various causes and its effective treatment has been diversely searched out until now. Currently used treatment modalities are intracordal injection of exogenous materials such as Teflon or Silicone, and thyroplasty and so forth. But, with the above mentioned modalities, it has been not satisfactory to obtain a good postoperative results especially in cases when the glottal incompetence is very severe or the level difference between the vocal cords is large. In such cases, vocal cord adduction can be accomplished by anteromedial traction of the muscular process of paralyzed vocal cord via surgical exposure resulting improvement of voice quality. Recently, authors performed arytenoid adduction in 3 cases of unilateral vocal cord paralysis to obtain a better improvement of voice quality, and experienced satisfiable postoperative results.

• Journal of Veterinary Clinics
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• v.38 no.5
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• pp.244-248
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• 2021

A 10-year-old Thoroughbred mare was referred to the Jeju National University Equine Hospital with roaring, dyspnea, and weight loss. On endoscopic examination, the horse was diagnosed with right arytenoid chondritis. Surgical treatment was selected due to the failure of a previous medical treatment. Permanent tracheostomy was performed in a standing position. The horse was restrained and tied in a proper position in the stock. The cranial parts of the 2nd to 5th tracheal cartilages were resected, as were the associated skin, mucosa, muscle, and cartilages. After the stoma was formed, external mucosa and skin were sutured using a simple interrupted method. The horse was hospitalized for 22 days receiving postoperative care including antibiotics, non-steroidal anti-inflammatory drugs, dressing as required, and was pregnant six months after the surgery. A permanent tracheostomy is thought to be effective in horses with diseases causing upper respiratory tract obstruction.

• Journal of Veterinary Science
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• v.23 no.4
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• pp.58.1-58.10
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• 2022

Background: Laryngeal paralysis is a common idiopathic degenerative neurological disease in older medium-to-large breed dogs, with surgical correction of the obstruction being the treatment of choice. Objectives: This study evaluated the use of laryngeal silicone stents to treat canine laryngeal paralysis in dogs where classic surgical treatment was not accepted by the owners. Methods: Dogs diagnosed with laryngeal paralysis, for which the owners refused arytenoid lateralization surgery as a first-line treatment, were treated with laryngeal silicone stents. Results: Six dogs with bilateral laryngeal paralysis were included in the study. All dogs showed improvement in clinical signs immediately after the procedure. No clinical signs or radiographic changes were noted in four out of six dogs in the follow-up visit performed 1 wk later. One dog was suspected of aspirating water while drinking, but the signs disappeared after repositioning the stent. Another dog had a relapse of stridor due to caudal migration of the stent. This dog underwent arytenoid lateralization surgery because larger stents are not commercially available. At the time of writing, between seven and 13 mon after stent placement, no significant incidents have occurred in four dogs, and all owners report a satisfactory quality of life. Conclusions: Laryngeal silicone stenting is an interesting alternative for treating dogs with acquired laryngeal paralysis when the owners refuse classic arytenoid lateralization surgery. Furthermore, stent placement can be a temporary solution to stabilize these dogs until a permanent surgical treatment can be performed.