Posterior Cricoid Split and Costal Cartilage Grafting for Bilateral Vocal Fold Paralysis

Video Type: CVideo
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Author: Katherine Dunsky
Published:
Specialties: Otolaryngology
Schools: Texas Children's Hospital
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Basic Info

Contributors: Noemie Rouillard-Bazinet and Julina Ongkasuwan

Bilateral vocal fold paralysis causes airway obstruction and, in some patients, tracheostomy dependence. Posterior cricoid split with costal cartilage grafting can open the posterior glottis and improving the airway.

DOI: http://dx.doi.org/10.17797/hyp0b3mzd5

Editor Recruited By: Michael M. Johns III, MD

Advanced

Procedure

Endoscopic posterior cricoid split with costal cartilage grafting

Indications

Bilateral Vocal fold paralysis

Contraindications

Instrumentation

Setup

Suspension laryngoscopy with laryngeal spreader for improved visualization. Accublade CO2 laser with a vertical line setting.

Preoperative Workup

Flexible laryngoscopy to assess vocal fold immobility

Anatomy and Landmarks

Advantages/Disadvantages

Does not destroy the vocal folds (allowing for possible laryngeal reinnervation (e.g. phrenic to PCA) or laryngeal pacing in the future. Potential risk for aspiration after surgery. Worsening of voice quality after surgery

Complications/Risks

Graft failure or displacement, aspiration, failure to decannulate or continued airway symptoms

Disclosure of Conflicts

none

Acknowledgements

References

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