Manish K. Wani, MD, Robert Yarber, MD,
Arne Hengesteg, Clark Rosen, MD, Gayle E. Woodson, MD
Bilateral laryngeal paralysis can result in severe airway compromise.
A widely accepted treatment is endoscopic laser total arytenoidectomy (TA):
however. vocal results are usually poor. An alternative approach, resection
of only the medial portion ofthe arytenoid (medial arytenoidectomy [MA]),
has the potential for less vocal impairment, but may not provide a sufficient
airway. Laryngeal resistance (LR) was measured in vivo and ex vivo in 12
adult mongrel dogs with bilateral laryngeal paralysis after TA, MA, or
no surgery (controls). The LR was significantly lower than in controls
in both TA and MA, but there was no significant difference between TA and
MA. Glottic area was also significantly higher in both MA and TA compared
to controls, but again, there was no .significant difference between TA
and MA. Phonation could be elicited in all controls and 2 of 4 dogs with
MA, but no dogs with TA. Our results show that MA offers airway improvement
similar to that with TA and also has the potential for better vocal function. |