The Laryngoscope · 2013
Excised larynx evaluation of wedge-shaped adjustable balloon implant for minimally invasive type I thyroplasty.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Hoffman Matthew R, Devine Erin E, McCulloch Timothy M, Jiang Jack J
Аннотация
OBJECTIVES/HYPOTHESIS: To describe the method of inserting a wedge-shaped adjustable balloon implant (wABI) via a minithyrotomy for medialization thyroplasty and evaluate its effect on a range of phonatory parameters using the excised larynx bench apparatus.
STUDY DESIGN: Repeated measures with each larynx serving as its own control.
METHODS: A prototype wABI was deployed in six excised canine larynges of various sizes through a minithyrotomy and then filled with saline. Mucosal wave, aerodynamic, and acoustic parameters were measured for three conditions: normal, vocal fold paralysis, and paralysis with the wABI.
RESULTS: Phonation threshold pressure (P < .001), flow (P < .001), and power (P = .002) were significantly lower for wABI compared to paralysis trials; values did not differ significantly from normal trials. Percent jitter (P = .002) and percent shimmer (P = .007) were also significantly decreased compared to the paralysis condition, and values were not significantly different compared to normal. The mucosal wave was preserved after insertion of the wABI.
CONCLUSIONS: Effective vocal fold medialization with preservation of the mucosal wave was observed with the wABI in this preliminary excised larynx experiment. The wABI offers the potential for a minimally invasive insertion in addition to postoperative adjustability. Further studies in living animals and humans are warranted to evaluate clinical utility.
LEVEL OF EVIDENCE: NA.
STUDY DESIGN: Repeated measures with each larynx serving as its own control.
METHODS: A prototype wABI was deployed in six excised canine larynges of various sizes through a minithyrotomy and then filled with saline. Mucosal wave, aerodynamic, and acoustic parameters were measured for three conditions: normal, vocal fold paralysis, and paralysis with the wABI.
RESULTS: Phonation threshold pressure (P < .001), flow (P < .001), and power (P = .002) were significantly lower for wABI compared to paralysis trials; values did not differ significantly from normal trials. Percent jitter (P = .002) and percent shimmer (P = .007) were also significantly decreased compared to the paralysis condition, and values were not significantly different compared to normal. The mucosal wave was preserved after insertion of the wABI.
CONCLUSIONS: Effective vocal fold medialization with preservation of the mucosal wave was observed with the wABI in this preliminary excised larynx experiment. The wABI offers the potential for a minimally invasive insertion in addition to postoperative adjustability. Further studies in living animals and humans are warranted to evaluate clinical utility.
LEVEL OF EVIDENCE: NA.