Minimally Invasive Unilateral Arytenoid Lateralization in Dogs - A Cadaveric Study

Introduction
Laryngeal paralysis is a condition in which there is partial or complete loss of the ability to abduct the arytenoid cartilages and vocal folds during inspiration. Although many procedures have been described, the method of choice is generally considered to be unilateral arytenoid lateralisation. The superficial location of the larynx, the location of the arytenoid cartilage medial to the thyroid cartilage and the ability to see into the larynx via an endoscope placed into the mouth provide all the necessary requirements for the development of a minimally invasive technique for unilateral arytenoid lateralisation. The aims of this study were to develop a percutaneous thyroarytenoid lateralisation (PTAL) technique, and to evaluate the effectiveness and safety of this technique on canine cadavers.

Materials and Methods
Eleven canine cadavers, weighing 15 kg to 37 kg, were used. The dogs were placed in ventral recumbency with the neck extended and the mouth open. A rigid endoscope was used to visualize the rima glottidis. The larynx was palpated and 2 hypodermic needles were passed through the skin into the lumen of the larynx, penetrating both the thyroid and arytenoid cartilages. Nylon suture material was passed through the needles to hold and retract the arytenoid cartilage. A key-hole approach to the larynx was performed and the suture material was knotted adjacent to the thyroid cartilage. The procedure was performed bilaterally and the change in the rima glottidis area after each procedure was recorded as were the duration of the procedure and complications encountered.  [...]