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Decision-Making in Arytenoid Adduction

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Decision Making in Vocal Fold Paralysis

Abstract

Arytenoid adduction (AA) is classified among the laryngeal framework surgeries. The purpose of AA is to stabilize and reposition the vocal process of the arytenoid. AA can be utilized alone or in combination with other procedures to statically reposition the vocal fold for rehabilitation of voice. Practice patterns vary widely, and controversy exists over the risk benefit ratio for performing AA. Some otolaryngologists consider AA a routine component of a primary vocal fold medialization, while others use it for select indications. During the preoperative period, it is important to consider paralysis etiology, the timing of surgery, and examination findings when planning AA. The surgery is considered technically challenging. As such, various anesthetic and technical modifications have occurred since the initial description by Isshiki in 1978. These modifications have made the procedure safer, more reliable, and more comfortable for patients. Optimal perioperative management reduces complications while minimizing unnecessary medications and length of stay. The AA plays an important role in revision surgery. Understanding the decisions around AA allows the laryngologist to confidently incorporate the procedure into the surgical armamentarium.

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Authors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    Benjamin J. Rubinstein

  2. Department of Otolaryngology – Head and Neck Surgery, Mount Sinai, New York, NY, USA

    Mark S. Courey

Authors
  1. Benjamin J. Rubinstein
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  2. Mark S. Courey
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Correspondence to Mark S. Courey .

Editor information

Editors and Affiliations

  1. NYU Swallowing Disorders Center, New York University, New York, NY, USA

    Milan R. Amin

  2. USC Voice Center, University of Southern California, Los Angeles, CA, USA

    Michael M. Johns

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Rubinstein, B.J., Courey, M.S. (2019). Decision-Making in Arytenoid Adduction. In: Amin, M., Johns, M. (eds) Decision Making in Vocal Fold Paralysis. Springer, Cham. https://doi.org/10.1007/978-3-030-23475-1_8

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  • DOI: https://doi.org/10.1007/978-3-030-23475-1_8

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