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Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2014;25(2): 90-95. |
| 측방접근법을 이용한 피열연골내전술 |
| 이낙준, 조정규, 김한결, 윤영선, 손영익 |
| 성균관대학교 의과대학 삼성서울병원 이비인후과학교실 |
| Arytenoid Adduction by Lateral Approach |
| Nak-Joon Lee, Jungkyu Cho, Han-Kyeol Kim, Young-Sun Yun, Young-Ik Son |
| Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine |
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| ABSTRACT |
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 Method
s : 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. |
| KEY WORDS：
Arytenoid adduction;Lateral approach;Unilateral vocal cord palsy;Hoarseness;Laryngoplasty; |
| 중심 단어：
피열연골내전술;측방접근법;성대마비;애성;후두주입술; |
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