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Microendoscopy of Reinke's Space (MERS)

last modified on: Mon, 03/18/2024 - 08:52

return to: Laryngeal Surgery (Benign Disease) Protocols

see also: MERS March 2010 Pig Experiment or Transilluminating Obturator

Microendoscopy of Reinke's space is a surgical procedure under development. It is an extension of the 'minithyrotomy' approach to Reinke's space developed by Steve Gray and successfully employed by Randy Paniello and others to treat disorders of Reinke's space (Wexler et al. 1989, Gray et al. 1999, Paniello et al. 2008). Preliminary human cadaver work has been published (Hoffman et al. 2008) and presented (Hoffman et al. 2009) identifying the utility of high resolution microendoscopes to image and direct dissection of Reinke's space through a percutaneous, trans-cricothyroid membrane puncture.

The light from the microendoscopes is visible through the vocal fold in the images above. A zero degree telescope was used to video-image the vocal folds as they would be seen through conventional microlaryngoscopy concurrently with the percutaneous MERS in this human cadaver larynx.

The video below identifies this approach employing a pig larynx to demonstrate dissection within Reinke's space.

Click on video below:


Wexler DB, Jiang J, Gray SD, Titze IR. Phonosurgical studies: fat-graft reconstruction of injured canine vocal cords. Ann Otol Rhinol Laryngol. 1989;98(9):668-73

Gray SD, Bielamowicz SA, Titze IR, Dove H, Ludlow C. Experimental approaches to vocal fold alteration: introduction to the minithyrotomy. Ann Otol Rhinol Laryngol. 1999;108(1):1-9

Paniello RC, Sulica L, Khosla SM, Smith ME. Clinical experience with Gray's minithyrotomy procedure. Ann Otol Rhinol Laryngol. 2008;117(6):437-442

Hoffman HT, Bock JM, Karnell LH, Ahlrichs-Hanson J. Microendoscopy of Reinke's space. Ann Otol Rhinol Laryngol., 2008 Jul:117(7):510-4; discussion 515-6.

Hoffman HT, Bock JM, Askeland RW, Ahlrichs-Hanson JS, and Van Daele DJ: Histologic Evaluation of Microendoscopy of Reinke's Space in Cadaveric Human Larynges presented at the Middle/Sourther Section of the Triologic Bonita Spring Florida Saturday am January 10, 2009