パネルディスカッション2 「喉頭機能外科手術を極める－喉頭枠組み手術－」
甲状軟骨形成術Ⅰ型
2019 年 31 巻 02 号 p. 112-116
詳細
2019 年 31 巻 02 号 p. 112-116
Preoperative examination : We created multi-planar reconstruction images from neck computed-tomography (CT) images. The form of the thyroid cartilage, position of the vocal folds, and degree of vocal fold atrophy can be evaluated from these images.
Type I thyroplasty : The fenestration design is a first-line priority during surgery. Although a chondrotomy is accomplished using a scalpel, a fissure bur may be necessary in cases with cartilage ossification. The fenestration is carefully created with the aim of preserving the cartilage and inner perichondrium. The vocal fold medialization procedure considers and adjusts to postoperative atrophy.
Titanium implant for type I thyroplasty : We examined the stability and permanence of fixation afforded by the titanium medialization laryngoplasty implant (TMLI), which was developed by the lead author. We evaluated implant migration, deformation, and fracture based on the postoperative neck CT images of 73 patients; however, no patients experienced any of these conditions. Thus, our results confirmed the stability and permanence of fixation following the placement of the TMLI. The implant also performed adequately in cases of reoperation.
