see also: Arytenoid Repositioning Device Video (2011 Experiment)
see also Transillumination technique (password protected):Transilluminating Obturator
ARD- Arytenoid Repositioning Device
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Standard approaches to arytenoid ad- and ab-duction require
- Neck incision
- Transection of muscles
- Removal of cartilage
- Mobilization of the pyriform sinus
- Dissection close to the carotid artery to place a suture in the muscular process of the arytenoid
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Placement of ARD (for ab- or ad-duction) - Small anterior neck incision
- No transection of muscles
- No removal of cartilage
- No mobilization of the pyriform sinus
- No dissection close to the carotid artery
to place the device employing an 18 guage trocar
through the cricothyroid membrane into the paraglottic
space to engage the muscular process of the arytenoid
ARD - - 'Minimal Access Surgery'
- Reversible
- Prmits positioning of arytenoid with greater precision than a suture
Adduction:
- Unilateral laryngeal paralysis
- Arytenoid subluxation/dislocation repositioning
Abduction:
- Bilateral laryngeal paralysis
- Acute placement (at time of thyroidectomy) chronic
- Posterior glottic scarring - ancillary measure to grafting
(kk 4-2-09)