Phonosurgery Training in Human Larynx Preserved with Thiel’s Embalming Method

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Jhonder Salazar ◽  
Juan-Ramón Gras ◽  
Luis Sanchez-Guillen ◽  
Francisco Sánchez-Del-Campo ◽  
Antonio Arroyo
Keyword(s):  
Anatomical Variation ◽  
Training Model ◽  
Injection Laryngoplasty ◽  
Tissue Quality ◽  
Vocal Cords ◽  
Living Body ◽  
Human Larynx ◽  
Unique Model ◽  
Glottal Insufficiency ◽  
Thiel’S Embalming Method

<b><i>Background:</i></b> To describe the suitability of larynges preserved with Thiel’s embalming method for phonosurgery training. <b><i>Methods:</i></b> A training model for phonosurgery techniques simulating vocal pathology and glottal insufficiency is developed to compare and evaluate the perception of embalmed vocal cords through a voluntary and anonymous survey rated on a scale of 1–5. A total of 10 residents and young otolaryngologists participated in the surgical training in phonosurgery. <b><i>Results:</i></b> Ten larynges preserved in formalin and 10 Thiel’s embalmed larynges were used for the investigation. Phonosurgery procedures were performed following microflap and injection laryngoplasty techniques. The larynges preserved with Thiel’s method demonstrated vocal cords that maintain their pliability and good tissue quality allowing a sensation of realism compared to the living body and providing suitable conditions for realistic laryngeal training. Participants held a positive experience, believed them to be useful and that these models of embalmed larynges were similar to the clinical setting and improved skills and confidence in performing phonosurgery. <b><i>Conclusions:</i></b> The human larynges embalmed with Thiel’s method maintain the pliability of the vocal cords, thus representing a unique model to practice and reproduce training for endolaryngeal procedures without the risks of contamination, anatomical variation, or rigidity of other models.

Resistance and reactance of the excised human larynx, trachea, and main bronchi

1987 ◽  
Vol 63 (5) ◽  
pp. 1788-1795 ◽  
Author(s):  
T. X. Jiang ◽  
M. Cauberghs ◽  
K. P. Van de Woestijne
Keyword(s):  
Steady Flow ◽  
Airway Resistance ◽  
Oscillatory Flow ◽  
Forced Oscillation ◽  
Upper Airway ◽  
Forced Oscillation Technique ◽  
Vocal Cords ◽  
Respiratory Flow ◽  
Human Larynx ◽  
Before And After

We investigated the impedance of excised preparations of the human larynx before and after resection of the vocal cords and of the trachea whether or not in connection with the main bronchi for steady (75–700 ml.s-1) and oscillatory flows (4–64 Hz). To simulate the influence of respiratory flow on oscillatory resistance (Rosc), oscillatory and steady flow were superimposed. This resulted in a marked increase of Rosc, dependent on the value of steady flow, a change of the frequency dependence of Rosc, and a decrease of the reactance. The latter effects were particularly pronounced in the preparations of the larynx, especially with a narrow glottis opening. The influence of steady flow on oscillatory resistances is probably the expression of interactions of steady and oscillatory flow regimes in the larynx. Similar but less pronounced interactions are also met in the trachea. These effects lead to a systematic overestimation of upper airway resistance when measured during spontaneous breathing by means of a forced oscillation technique.

scholarly journals A New Injection Laryngoplasty Using Hyaluronic Acid for the Treatment of Glottal Insufficiency

2008 ◽  
Vol 20 (2) ◽  
pp. 133-137
Author(s):  
Toshiyuki Kusuyama ◽  
Yuko Mori ◽  
Makoto Miyamoto ◽  
Hideki Nakagawa ◽  
Etsuyo Tamura ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Injection Laryngoplasty ◽  
Glottal Insufficiency

scholarly journals Changes in Abnormal Muscle Tension Pattern after Fiberoptic Injection Laryngoplasty

2017 ◽  
Vol 96 (12) ◽  
pp. 472-476 ◽  
Author(s):  
Georges Ziade ◽  
Ghassan Haddad ◽  
Sarah Assaad ◽  
Maher Kasti ◽  
Abdul-Latif Hamdan
Keyword(s):  
Medical Records ◽  
Vocal Fold ◽  
Chart Review ◽  
Muscle Tension ◽  
Retrospective Chart Review ◽  
Injection Laryngoplasty ◽  
Before And After ◽  
Glottal Insufficiency ◽  
The Mean ◽  
Positive Effect

We performed a retrospective chart review to compare the presence and types of abnormal muscle tension patterns (MTPs) in patients who had been diagnosed with glottal insufficiency before and after fiberoptic injection laryngoplasty. The main cause of glottal insufficiency had been unilateral vocal fold paralysis. Our review included an analysis of the medical records and laryngeal videostroboscopic recordings of 16 patients—9 men and 7 women, aged 25 to 87 years (mean: 59). Stroboscopic frames were analyzed for the presence of one or more types of abnormal MTP. Statistical analysis was performed to determine the significance of the change in scores for type II and type III MTP before injection and 1 month after injection. Before injection laryngoplasty, 15 of the 16 patients exhibited evidence of an abnormal MTP; 10 patients had MTP II only, 2 had MTP III only, and 3 patients had both. The mean percentage of frames showing MTP (i.e., MTP score) in patients with MTP II was 66.2% before the injection and 28.9% 1 month after; the decrease was statistically significant (p = 0.001). For MTP III, the corresponding figures were 71.6 and 37.7% (p = 0.043). We conclude that injection laryngoplasty has a positive effect on reducing muscle tension in patients with glottal insufficiency.

Injection laryngoplasty as an effective treatment method for glottal insufficiency in aged patients

2021 ◽  
pp. 103353
Author(s):  
Beata Miaśkiewicz ◽  
Aleksandra Panasiewicz-Wosik ◽  
Katarzyna Nikiel ◽  
Elżbieta Gos ◽  
Małgorzata Dębińska ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Treatment Method ◽  
Injection Laryngoplasty ◽  
Aged Patients ◽  
Glottal Insufficiency

scholarly journals Outcomes versus complications in patients undergoing different modalities of injection laryngoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohamed E. Darweesh ◽  
Aml F. Y. El-Gazzar ◽  
Shaimaa M. Sarag ◽  
Ayat-Allah Raouf Sheikhany
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Folds ◽  
Complication Rates ◽  
Injection Laryngoplasty ◽  
Vocal Fold Injection ◽  
Glottal Insufficiency ◽  
Sulcus Vocalis

Abstract Background Glottal insufficiency results in glottal gap between the two vocal folds, which in turn might cause dysphonia, dysphagia, and breathing problems. Vocal fold injection is considered a safe, reliable, and highly effective method of treatment. The purpose of the present study was to assess voice outcomes and complication rates in patients with glottal insufficiency undergoing injection laryngoplasty (IL) under local versus general anesthesia before, 1 week then 1 month after IL. Results Examined patients were 13 males and 12 females, suffering from dysphonia due to glottal insufficiency with mean age 43.68 ± SD 14.55. Unilateral vocal fold paralysis (UVFP) was diagnosed in seventeen cases, vocal fold scarring in six cases, presbylarynx in one case, and sulcus vocalis in one case. IL was performed in 18 cases under local anesthesia, and 7 under general anesthesia. Hyaluronic acid was injection material in 23 cases and calcium hydroxylapatite in two cases. IL by either local or general anesthesia has improved the patients’ auditory perceptual analysis of voice quality as assessed by “GRBAS” scale and Voice Handicap Index (VHI). There were four (16% of all injections) minor and self-limited complications (12% under local and 4% under general anesthesia). Conclusion Injection laryngoplasty performed under local and general anesthesia offers similar voice outcomes, but with slightly higher self-limited complications in IL under local anesthesia.

“ROLE OF ULTRASOUND IN VOCAL CORD PALSY”

2021 ◽  
pp. 33-38
Author(s):  
Utkarsh Garg ◽  
Harneet Narula ◽  
Manish Gupta ◽  
Ujjwala Singh ◽  
Shreya Singh
Keyword(s):  
Pressure Drop ◽  
Vocal Cord ◽  
Fundamental Frequency ◽  
Vocal Cord Palsy ◽  
Harmonic Series ◽  
Fundamental Tone ◽  
Vocal Cords ◽  
Human Larynx ◽  
Main Component

Phonation is beyond doubt one of the highest functions of the human larynx. The vocal cords, also known as vocal cords, as the name suggests are infolding of mucosa aligned horizontally. The phonatory process, or voicing, occurs when air is expelled from the lungs through the glottis, creating a pressure drop across the larynx. When this drop becomes sufciently large, the vocal cords start to oscillate. The motion of the vocal cords during oscillation is mostly lateral, though there is also some superior component as well. However, there is almost no motion along the length of the vocal cords. The oscillation of the vocal cords serves to modulate the pressure and ow of the air through the larynx, and this modulated airow is the main component of the sound. The sound that the larynx produces is a harmonic series. In other words, it consists of a fundamental tone (called the fundamental frequency, the main acoustic cue for the percept pitch) accompanied by harmonic overtones, which are multiples of the (1) fundamental frequency .

Novel Porcine Kidney-Based Microsurgery Training Model for Developing Basic to Advanced Microsurgical Skills

2020 ◽  
Author(s):  
Jose Maciel Caldas dos Reis ◽  
Renan Kleber Costa Teixeira ◽  
Deivid Ramos dos Santos ◽  
Faustino Chaves Calvo ◽  
Nayara Pontes de Araújo ◽  
...  
Keyword(s):  
Average Duration ◽  
Anatomical Variation ◽  
Training Model ◽  
High Fidelity ◽  
Porcine Kidney ◽  
Venous Anastomosis ◽  
Simulation Based ◽  
Complex Skills ◽  
Vascular Structures ◽  
Different Levels

Abstract Background Microsurgery training is critical to the practice of microvascular procedures in many surgical areas. However, even simple procedures require different levels of complex skills. Therefore, simulation-based surgical training, mainly in the area of vascular anastomosis, is of great importance. In this paper, we present a new microsurgery training model for the development of basic to advanced microsurgical skills. Methods Porcine kidneys were purchased from a legal butchery slaughterhouse. First, kidneys were washed with water to remove blood and clots inside vessels. Then, dissection was performed throughout the vascular pedicle from the renal arteries to the segmentary branches. Finally, the longitudinal sectioning of the kidney parenchyma was performed to expose the vessels necessary for training. Sixty end-to-end anastomoses were performed. Specific instruments and materials were used to perform anastomoses and dissections with magnification by a video system. We evaluated the diameter of vessels, time to perform anastomosis, and patency of anastomosis. Results There was no great anatomical variation among the porcine kidneys. The total length for dissection training was 25.80 ± 7.44 cm using the arterial and venous vessel. The average time to perform arterial anastomoses was 23.79 ± 4.55 minutes. For vessel diameters of ≤ 3, 4 to 6, and 7 to 10 mm, the average procedure times were 27.68 ± 3.39, 22.92 ± 4.12, and 20.77 ± 3.44 minutes, respectively. Regarding venous anastomosis, the average duration of the procedure was 26.17 ± 4.80 minutes, including durations of 31.61 ± 3.86, 25.66 ± 4.19, and 21.24 ± 3.79 minutes for vessel diameters of ≤ 7, 8 to 10, and >10 mm, respectively. Positive patency was achieved in all surgeries. Conclusion The porcine kidney provides an inexpensive and convenient biological model for modeling microanastomosis with high fidelity to vascular structures.

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