Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach
ObjectivesThese days, the main injection laryngoplasty technique is cricothyroid (CT) approach. However, patients who have previously undergone other neck treatments, such as thyroidectomy or neck dissection have distorted anatomical landmark makes this approach more difficult. The aim of this study...
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| Format: | Article |
| Language: | English |
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Korean Society of Otorhinolaryngology-Head and Neck Surgery
2010-03-01
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| Series: | Clinical and Experimental Otorhinolaryngology |
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| Online Access: | http://www.e-ceo.org/upload/pdf/ceo-3-37.pdf |
| _version_ | 1828422013812736000 |
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| author | Seung Won Lee Jae Wook Kim Yoon Woo Koh Sung Shine Shim Young Ik Son |
| author_facet | Seung Won Lee Jae Wook Kim Yoon Woo Koh Sung Shine Shim Young Ik Son |
| author_sort | Seung Won Lee |
| collection | DOAJ |
| description | ObjectivesThese days, the main injection laryngoplasty technique is cricothyroid (CT) approach. However, patients who have previously undergone other neck treatments, such as thyroidectomy or neck dissection have distorted anatomical landmark makes this approach more difficult. The aim of this study is to determined the efficiency of transcartilaginous (TC) approah as compared with CT approach for unilateral vocal fold paralysis patients, especially for previously neck treated patients.MethodsFrom March 2005 to February 2008, 137 consecutive injection laryngoplasties were performed in patients with unilateral glottic insufficiency. Percutaneous injection was performed under local anesthesia into the vocalis muscle, using disposable 25 G 4 cm long needles through the cricothyroid membrane or directly through the thyroid cartilage. Of the 137 patients, 124 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 3 months after the injection.ResultsIn the 124 patients, the CT and TC approaches were used in 94 and 30 patients, respectively. Acoustic and perceptual parameters (GRBAS, MPT, jitter, shimmer), voice handicap index, and grades of mucosal waves and glottic closure were significantly improved after the injection in both the CT and TC groups (P<0.05). Only two patients (6.6%) had penetration difficulties, because of ossification of the thyroid cartilage. The overall success rates of the CT and TC approaches were 86.2%, 93.3%, respectively. However, the success rate of the TC approach in patients who had previously undergone neck treatments was significantly higher than that of the CT approach (100% vs. 65% P<0.05).ConclusionBased on the preliminary results of this trial, injection laryngoplasty using a TC approach was an effective alternative to the CT approach, especially in patients who had previously undergone neck surgeries. |
| first_indexed | 2024-12-10T15:41:39Z |
| format | Article |
| id | doaj.art-e8007cabcf424e4ba26e0934ee569602 |
| institution | Directory Open Access Journal |
| issn | 1976-8710 2005-0720 |
| language | English |
| last_indexed | 2024-12-10T15:41:39Z |
| publishDate | 2010-03-01 |
| publisher | Korean Society of Otorhinolaryngology-Head and Neck Surgery |
| record_format | Article |
| series | Clinical and Experimental Otorhinolaryngology |
| spelling | doaj.art-e8007cabcf424e4ba26e0934ee5696022022-12-22T01:43:06ZengKorean Society of Otorhinolaryngology-Head and Neck SurgeryClinical and Experimental Otorhinolaryngology1976-87102005-07202010-03-0131374110.3342/ceo.2010.3.1.37112Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid ApproachSeung Won Lee0Jae Wook Kim1Yoon Woo Koh2Sung Shine Shim3Young Ik Son4Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea.Department of Otolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.ObjectivesThese days, the main injection laryngoplasty technique is cricothyroid (CT) approach. However, patients who have previously undergone other neck treatments, such as thyroidectomy or neck dissection have distorted anatomical landmark makes this approach more difficult. The aim of this study is to determined the efficiency of transcartilaginous (TC) approah as compared with CT approach for unilateral vocal fold paralysis patients, especially for previously neck treated patients.MethodsFrom March 2005 to February 2008, 137 consecutive injection laryngoplasties were performed in patients with unilateral glottic insufficiency. Percutaneous injection was performed under local anesthesia into the vocalis muscle, using disposable 25 G 4 cm long needles through the cricothyroid membrane or directly through the thyroid cartilage. Of the 137 patients, 124 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 3 months after the injection.ResultsIn the 124 patients, the CT and TC approaches were used in 94 and 30 patients, respectively. Acoustic and perceptual parameters (GRBAS, MPT, jitter, shimmer), voice handicap index, and grades of mucosal waves and glottic closure were significantly improved after the injection in both the CT and TC groups (P<0.05). Only two patients (6.6%) had penetration difficulties, because of ossification of the thyroid cartilage. The overall success rates of the CT and TC approaches were 86.2%, 93.3%, respectively. However, the success rate of the TC approach in patients who had previously undergone neck treatments was significantly higher than that of the CT approach (100% vs. 65% P<0.05).ConclusionBased on the preliminary results of this trial, injection laryngoplasty using a TC approach was an effective alternative to the CT approach, especially in patients who had previously undergone neck surgeries.http://www.e-ceo.org/upload/pdf/ceo-3-37.pdfInjection laryngoplastyThyroid cartilageVocal cord paralysis |
| spellingShingle | Seung Won Lee Jae Wook Kim Yoon Woo Koh Sung Shine Shim Young Ik Son Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach Clinical and Experimental Otorhinolaryngology Injection laryngoplasty Thyroid cartilage Vocal cord paralysis |
| title | Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach |
| title_full | Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach |
| title_fullStr | Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach |
| title_full_unstemmed | Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach |
| title_short | Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach |
| title_sort | comparative analysis of efficiency of injection laryngoplasty technique for with or without neck treatment patients a transcartilaginous approach versus the cricothyroid approach |
| topic | Injection laryngoplasty Thyroid cartilage Vocal cord paralysis |
| url | http://www.e-ceo.org/upload/pdf/ceo-3-37.pdf |
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