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At least 883 records · Page 49Linked to original sources
PubMed1987

The anterior cricoid split explored via the canine model, preliminary studies.

Since Cotton and Seid introduced a new surgical procedure, the anterior cricoid split in 1980, the treatment of the difficult-to-extubate infant or child has changed dramatically. The mechanics of how the procedure works are poorly understood. This study was undertaken to investigate the effects of the anterior cricoid split on the cricoid cartilage. The technique was modified so as to allow placement and maintenance of an endotracheal tube but still allow normal activity in the canine subjects. Australian Shepherd puppies were divided into 3 groups. Group 1 underwent the anterior cricoid split procedure with placement of an endotracheal tube stent, Group 2 underwent the anterior cricoid split procedure without the use of a stent, and Group 3 served as controls. All animals were sacrificed at 12 weeks of age. The results show that there was an actual gap in the cricoid cartilage in all animals that underwent the anterior cricoid split procedure. Stenting with an endotracheal tube significantly increased this gap. These results suggest that in the canine model the anterior cricoid split may be used to actually increase the size of the subglottic space.

Animals↗
PubMed1988

Dorsal glottic stenosis after bilateral arytenoidectomy in two horses.

Bilateral arytenoidectomy had been performed as treatment for bilateral arytenoid chondritis in 2 horses. After surgery, dorsal mucosal defects were associated with subsequent development of dorsal glottic stenosis in the 2 horses. When performing bilateral arytenoidectomy in the horse, care must be taken to eliminate dorsal mucosal defects that cross the midline. Failure to close these defects may result in glottic stenosis.

Animals↗
PubMedDate not supplied

[Traumatic subcutaneous ruptures of the cervical trachea (author's transl)].

Traumatic subcutaneous rupture of the cervical trachea is a rare but serious lesion that may cause death of the patient. Few cases come to treatment. This lesion results from a contusion to the anterior neck during hyperextension. It consists in a straight transection between larynx and trachea or between one of the 4 first tracheal rings, and is usually associated to multiple trauma involving the chest and head. Specific symptoms are often blurred by those of the associated lesions making diagnosis complex. This should ideally be confirmed by endoscopy or, if not feasable by cervicotomy. Emergency treatment is directed to restablishment of an adequate ventilation. Direct anastomosis by separate resorbable sutures yields excellent long-term results without stenosis. Creation of a transitory tracheotomy, when commanded by regional atresion, sometimes induces late stenosis; secondary repair is then less favorable. The rate of definitive recurrent nerve paralysis is high. There are also frequent distortions of the vocal cords with modifications of the voice and transitory palsy of the phrenic nerve. The authors draw these conclusions from one personal case and from the literature.

Accidents, Traffic↗
PubMed1982

[Cicatricial stenosis in the crico-tracheal region. A new surgical approach].

Nearly a half of laryngo-tracheal cicatrical stenoses following long-term intubation are found at the level of the cricoid cartilage. Early and correctly-performed tracheotomy can prevent this complication in almost all cases. The best results of surgical treatment can be expected after transverse partial resection of cricoid and upper trachea or after Réthi's laminotomy. In 14 patients after cricotomy a bone graft from the manubrium sterni was inserted, to separate permanently the free borders of the divided cricoid cartilage. Operative technics and the results of treatment are presented.

Adolescent↗
PubMed1981

Paralaryngeal abscess with laryngeal hemiplegia and fistulation in a horse.

A three year old Thoroughbred filly was examined because of bilateral nasal discharge and external swelling of the left laryngeal area. Endoscopy revealed an enlarged left arytenoid cartilage, left laryngeal hemiplegia and drainage of purulent material into the lumen of the larynx. Radiographs showed a large fluid and gas filled cavity overlying the caudal larynx and cranial trachea. Surgical drainage and debridement of the abscess led to complete healing by secondary intention. Laryngeal ventriculectomy was performed as a treatment for left laryngeal hemiplegia, but a grave prognosis for respiratory soundness was given due to the extensive laryngeal fibrosis. The etiology of the Staphylococcus aureus abscess is unknown but may have originated from oral trauma to the larynx.

Abscess↗
PubMed1981

[Report on the indication, technique and functional results of endolaryngeal arytenoidectomy and submucous partial chordectomy in bilateral paralysis of vocal cord (author's transl)].

In 116 patients the further course of disease could be followed up. In all, 114 patients with mostly very satisfactory voice results could be primarily decannulated. In 69.7% of the patients, the decannulation took place between the 5th and 15th postoperative day, in 25.1% between 16 to 40 days. In one patient the decannulation could only be carried out after a second operation (laminotomy of the cricoid plate). This endolaryngeal arytenoidectomy can be considered therefore as a very reliable method with regard to a glottic dilation adapted to individual needs, permits quick decannulation and is well tolerated by the patients.

Adolescent↗
PubMedDate not supplied

An in vitro comparison of cordopexy, cordopexy and laryngoplasty, and laryngoplasty for treatment of equine laryngeal hemiplegia.

OBJECTIVE: To examine the effect of cordopexy, laryngoplasty, and cordopexy combined with a modified laryngoplasty on airway mechanics. STUDY DESIGN: Experimental airway mechanics were determined by subjecting equine cadaveric larynges to airflows similar to inspiratory airflow of exercising horses. ANIMALS OR SAMPLE POPULATION: Twenty equine larynges. METHODS: Using cadaveric larynges, we developed and tested a new technique of arytenoid cartilage abduction. All larynges had the right arytenoid cartilage abducted to mimic the degree of arytenoid abduction that occurs at maximal exertion in live horses. Three surgical techniques were used to stabilize the left arytenoid cartilage of treated larynges; the left arytenoid cartilage was not stabilized in control larynges. Technique 1: Cordopexy--a suture was placed between the vocal ligament and the lamina of the thyroid cartilage. Technique 2: Standard laryngoplasty--a suture was placed between the muscular process of the arytenoid cartilage and the caudomedial aspect of the cricoid cartilage. Technique 3: Cordopexy plus modified laryngoplasty--the cordopexy suture was placed with a second suture between the horizontal ridge rostral to the muscular process of the left arytenoid cartilage and the lamina of the thyroid cartilage. Translaryngeal impedances (TI) were determined for each surgical technique by subjecting the larynges to increasing airflows and measuring the translaryngeal pressure differences. The arytenoid right to left angle quotient (RLQ) and the glottic cross-sectional area (CSA) were also measured. RESULTS: At maximal airflow, the adjusted means for the arytenoid RLQ and the TI for the cordopexy plus modified laryngoplasty (1.48 +/- 0.04, 0.69 +/- 0.05 cm H2O/L/s) and the standard laryngoplasty (1.39 +/- 0.04, 0.78 cm H2O/L/s) were different (P < .05) from values obtained after cordopexy alone (2.74 +/- 0.37, 1.76 +/- 0.48 cm H2O/L/s) or in control larynges (3.66 +/- 0.54, 4.16 +/- 0.96 cm H2O/L/s). Overall, a cordopexy plus modified laryngoplasty (9.69 cm2), a standard laryngoplasty (9.34 cm2), and a cordopexy alone (9 cm2) resulted in an increased glottic CSA greater than that for control larynges (6.94 cm2; P = .0001). CONCLUSIONS: Cordopexy alone did not improve airflow in a left laryngeal hemiplegic model. Cordopexy plus modified laryngoplasty was as efficacious as the standard laryngoplasty in alleviating the effects of left laryngeal hemiplegia on TI, glottic CSA, and arytenoid RLQ. CLINICAL RELEVANCE: Fixation of the vocal cord (cordopexy) in addition to a laryngoplasty procedure may prove useful in the surgical treatment of equine laryngeal hemiplegia.

Animals↗
PubMed2005

[Reconstruction of laryngeal defect in vertical partial laryngectomy with resection of arytenoid cartilage].

OBJECTIVE: To discuss the method to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage. METHODS: Laryngeal defect was reconstructed with local tissues after vertical partial laryngectomy with resection of arytenoid cartilage on 87 patients with laryngeal carcinoma of glottic type (T1 7 cases, T2 54 cases, T3 26 cases). All the lesions invaded arytenoid area or vocal process. No filling tissues were used to increase the height of affected arytenoid area and no skin flap or other tissues were used to reconstruct the vocal cord in all the patients. RESULTS: All the patients recovered normal swallow in 8 to 19 days postoperation and restored phonation. The decannulation rate was 98.9% (86/87). There were no pharyngeal fistula and pulmonary complications after operation. Local infection occurred in 3 patients and was cured in 7 days. The rate of local recurrence and cervical lymph node metastasis were 8.0% (7/87), 6.9% (6/87) respectively. Lost patients were assumed to death and direct method was used to calculate survival rate. In 87 patients postoperative period was above 3 years, 5 died in 3 years and 3 were lost 3- year survival rate was 90.8% (79/87). In 63 patients postoperative period was above 5 years, 10 died in 5 years and 2 were lost. 5- year survival rate was 81.0% (51/63). CONCLUSIONS: Utilizing local tissues to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage will not lead to severe dysphagia. Phonation is acceptable. It not only saves the operation time but also avoids the negative effects of immoderate reparation.

Adult↗
PubMed1977

Synthesis of cartilage-specific proteoglycan by suspension cultures of adult chondrocytes.

Chondrocytes isolated from larynges of adult pigs were cultured as cell suspensions for at least 4 days before use. During continuous-labelling experiments in nutrient medium for 18h with 35SO42- and [3H]glucosamine as precursors, some macromolecular polyanionic material was synthesized which behaved on gel chromatography as proteoglycan. Gel chromatography on Sepharose 2B showed that a proportion of the proteoglycans in the medium appeared to be aggregated, and was dissociated in 4M-guanidinium chloride. Moreover the dissociated proteoglycan interacted with hyaluronic acid. Newly synthesized proteoglycan was larger than the average total cetylpyridinium chloride-precipitable material assayed as uronic acid alone.

Animals↗