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'Flaccid neoglottis' following supracricoid partial laryngectomy: laryngoscopic revision assisted by navigation system.
MedLine Citation:
PMID:  21888753     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:Supracricoid partial laryngectomy is a reliable laryngeal preservation procedure for tumour stage 2 and selected stage 3 to 4 laryngeal cancers. Of 70 patients thus treated, two (3 per cent) had 'flaccid neoglottis', i.e. redundant mucosa at the inner arytenoid edge which intermittently obstructed the neoglottis. We discuss the mechanism and management of this complication.Method:The two cases are presented. A navigation system was used to assist surgery. Neoglottal spatial alteration (specifically cross-sectional area) was assessed pre- and post-operatively using three-dimensional computed tomography. Voice was also evaluated.Results:Inspiratory stridor and delayed stomal closure were the main symptoms. Minimum neoglottal cross-sectional area was smaller in case one than in non-affected patients. Both patients had relatively rougher and breathier voices, but had adapted well to this.Conclusion:Flaccid neoglottis is mainly due to excessive anterior retraction of residual laryngeal mucosa and to excessive mucosal pliability with age. A navigation system was useful for confirmation, but the potential for incorrect image recognition should be kept in mind. Flaccid neoglottis was treatable, with improved laryngeal function.
Authors:
M Nakayama; Y Seino; M Okamoto; T Matsuki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-5
Journal Detail:
Title:  The Journal of laryngology and otology     Volume:  -     ISSN:  1748-5460     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706896     Medline TA:  J Laryngol Otol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-5     Citation Subset:  -    
Affiliation:
Department of Otorhinolaryngology, Kitasato University School of Medicine, Kanagawa, Japan.
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