PMID- 27916331
OWN - NLM
STAT- MEDLINE
DCOM- 20180423
LR  - 20180423
IS  - 1873-4588 (Electronic)
IS  - 0892-1997 (Linking)
VI  - 31
IP  - 4
DP  - 2017 Jul
TI  - Modifications to the Fenestration Approach for Arytenoid Adduction Under Local 
      Anesthesia.
PG  - 490-494
LID - S0892-1997(16)30348-4 [pii]
LID - 10.1016/j.jvoice.2016.10.019 [doi]
AB  - OBJECTIVE: We modified the fenestration approach for arytenoid adduction to make 
      it easier to perform the surgery. The aim of this study was to evaluate the 
      usefulness of our modifications, which included (1) use of an Alexis wound 
      retractor (Applied Medical) to secure the surgical field through a small 
      incision, and (2) use of a 12-mm, 1/2 R, insert-molded taper needle with 3-0 
      nylon suture to prevent damage to the arytenoid cartilage. STUDY DESIGN: This is 
      a retrospective non-randomized observational cross-sectional study. METHODS: We 
      compared the operative time and skin incision length between the conventional 
      fenestration approach and our modified procedure, and verified the improvement of 
      patients' voice by our procedure. RESULTS: Seven patients underwent the 
      conventional fenestration approach for arytenoid adduction with type I 
      thyroplasty, whereas nine patients underwent our modified fenestration approach 
      for arytenoid adduction with type I thyroplasty. The skin incision length with 
      our modifications (median, 3.0 cm; interquartile range [IQR], 3.0-4.0) was 
      significantly shorter than with the conventional procedure (median, 5.0 cm; IQR, 
      4.3-5.8) (P = 0.001). The operative time with our modifications (median, 95 
      minutes; IQR, 90-100) was significantly shorter than without our modifications 
      (median, 115; IQR, 100-130) (P = 0.035). All patients who underwent our modified 
      fenestration approach for arytenoid adduction had maximum phonation time greater 
      than 11 seconds after surgery. CONCLUSIONS: Our two distinctive modifications 
      reduced the operative time and skin incision length for the fenestration 
      approach, which improved the procedure by making it less invasive.
CI  - Copyright (c) 2017 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Fukuhara, Takahiro
AU  - Fukuhara T
AD  - Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of 
      Medicine, Yonago, Japan. Electronic address: tfukuhara3387@med.tottori-u.ac.jp.
FAU - Morisaki, Tsuyoshi
AU  - Morisaki T
AD  - Center for Head and Neck Surgery, Kusatsu General Hospital, Kusatsu, Japan.
FAU - Kataoka, Hideyuki
AU  - Kataoka H
AD  - Division of Medical Education, Department of Social Medicine, Tottori University 
      Faculty of Medicine, Yonago, Japan.
FAU - Miyake, Naritomo
AU  - Miyake N
AD  - Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of 
      Medicine, Yonago, Japan.
FAU - Taira, Kenkichiro
AU  - Taira K
AD  - Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of 
      Medicine, Yonago, Japan.
FAU - Koyama, Satoshi
AU  - Koyama S
AD  - Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of 
      Medicine, Yonago, Japan.
FAU - Fujiwara, Kazunori
AU  - Fujiwara K
AD  - Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of 
      Medicine, Yonago, Japan.
FAU - Kitano, Hiroya
AU  - Kitano H
AD  - Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of 
      Medicine, Yonago, Japan.
FAU - Takeuchi, Hiromi
AU  - Takeuchi H
AD  - Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of 
      Medicine, Yonago, Japan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20161201
PL  - United States
TA  - J Voice
JT  - Journal of voice : official journal of the Voice Foundation
JID - 8712262
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anesthesia, Local
MH  - Arytenoid Cartilage/*surgery
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Otorhinolaryngologic Surgical Procedures/*methods
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Arytenoid adduction
OT  - Recurrent nerve palsy
OT  - Thyroplasty
OT  - Vocal palsy
OT  - Wound retractor
EDAT- 2016/12/06 06:00
MHDA- 2018/04/24 06:00
CRDT- 2016/12/06 06:00
PHST- 2016/09/01 00:00 [received]
PHST- 2016/10/21 00:00 [revised]
PHST- 2016/10/26 00:00 [accepted]
PHST- 2016/12/06 06:00 [pubmed]
PHST- 2018/04/24 06:00 [medline]
PHST- 2016/12/06 06:00 [entrez]
AID - S0892-1997(16)30348-4 [pii]
AID - 10.1016/j.jvoice.2016.10.019 [doi]
PST - ppublish
SO  - J Voice. 2017 Jul;31(4):490-494. doi: 10.1016/j.jvoice.2016.10.019. Epub 2016 Dec 
      1.