Intralaryngeal thyroarytaenoid lateralisation using the Fast-Fix 360 system: a canine cadaveric study

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Abstract

Introduction

Laryngeal paralysis is a condition in which failure of arytaenoid abduction results in a reduced rima glottidis cross-sectional area. The most commonly performed surgical techniques rely on unilateral abduction of the arytaenoid, requiring a lateral or ventral surgical approach to the larynx.

Aims and objectives

The aim of the study was to investigate a novel minimally invasive intralaryngeal thyroarytaenoid lateralisation technique, using the Fast-Fix 360 meniscal repair system.

Materials and methods

Larynges were harvested from large breed canine cadavers. With the aid of Kirschner wires placed between the centre of the vocal process and the centre of an imaginary line between the cranial thyroid fissure and the cricothyroid articulation, the mean insertion angle was calculated.

Results

The Fast-Fix 360 delivery needle inserted intralaryngeally (n=10), according to a simplified insertion angle (70°), resulted in thyroid penetration (>2.5 mm from margin) in all patients. The Fast-Fix was applied unilaterally at 70° with the first toggle fired on the lateral aspect of the thyroid cartilage and inside the laryngeal cavity on retraction. The suture was tightened. Preprocedural (61.06±9.21 mm2) and postprocedural (138.37±26.12 mm2) rima glottidis cross-sectional area was significantly different (P<0.0001). The mean percentage increase in rima glottidis cross-sectional area was 125.96 per cent (±16.54 per cent).

Conclusion

Intralaryngeal thyroarytaenoid laterlisation using the Fast-Fix 360 meniscal repair system ex vivo increased the rima glottidis cross-sectional area significantly.

Related collections

Most cited references 19

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Bacterial adherence to surgical sutures. A possible factor in suture induced infection.

D Mirelman, M Izhar, Paul S. Katz (1981)

Surgical sutures are known to potentiate the development of wound infection. The purpose of this study was to investigate whether the capability of bacteria to adhere to various types of sutures has a significant effect on their ability to cause infections. Bacterial adherence to sutures was quantitatively measured using radiolabeled bacteria. In vitro adherence assays revealed remarkable variations in the affinity of bacteria to the various sutures: nylon bound the least bacteria while bacterial adherence to braided sutures (silk, Ti-cron, Dexon) was five to eight folds higher. The degree of infection obtained in mice in the presence of different sutures nicely correlated with their adherence properties. The different removal rate of adherent bacteria (glutaraldehyde-fixed) from various sutures by the tissue factors in mice supports the hypothesis that bacterial adherence to suture materials plays a significant role in the induction of surgical infection. Our observation points out at the need for careful suture selection in contaminated wounds. The adherence properties of sutures should be considered in any future surgical suture design.

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Meniscal repair using the FasT-Fix all-inside meniscal repair device.

Nicholas Hornstein, A Schepsis, Jamie Haas … (2005)

We performed a prospective study of meniscal repair using a new all-inside suture meniscal repair device to evaluate its clinical efficacy. Prospective case series. The results of 42 meniscal tears in 37 patients who underwent meniscal repair using the FasT-Fix device (Smith & Nephew, Andover, MA) were prospectively evaluated. All cases were performed by 1 surgeon (A.A.S.). Preoperative and follow-up evaluation was performed using the objective and subjective International Knee Documentation Committee (IKDC) criteria as well as Lysholm functional questionnaires. Statistical significance was determined to be P < .05 based on a 2-tailed t test. Relook arthroscopy was performed in 8 patients (9 repairs). Any patient who had a hybrid repair was excluded. The patient population studied, 37 patients comprising 42 meniscal repairs, had an average age of 27 years (range, 13 to 48 years), and an average follow-up of 24.3 months (range, 22 to 27 months). There were 20 male and 18 female patients with 23 medial and 9 lateral repairs; 5 patients had both menisci repaired. All patients had tears in Cooper radial zones 1 and 2 and, thus, had a peripheral meniscal rim of at least 2 mm. All tears were predominantly in the middle and posterior third of the meniscus and 8 tears extended into the posteriormost aspect of the anterior third of the meniscus. An average of 2.8 suture devices was used (range, 1 to 5), predominantly in a vertical or vertical oblique mattress configuration. Forty-two percent were isolated meniscal injuries and 58% had a concurrent anterior cruciate ligament (ACL) reconstruction. Concomitant procedures were ACL reconstruction in 22, excision of loose body in 1, and excision of a large meniscal cyst in 1. Tear length averaged 2.9 cm (range, 1.5 to 4.5 cm). The success rate by objective IKDC score was 86% (73% normal, 13% nearly normal, and 14% abnormal). Of the 5 clinical failures, 3 were in the isolated group (80% success rate), and 2 were in the ACL group (91% success rate). Both the subjective IKDC and the Lysholm scores statistically improved (IKDC average, 59 preoperative and 92 postoperative; Lysholm average, 69 preoperative and 94 postoperative). There were 8 relook arthroscopies; 5 for failures and 3 for other procedures at which time complete healing was noted. In no case was there articular scuffing from the knots. Removal of a device at the time of surgery was necessary in 5 instances for failure of engagement of the T-Fix bar. An additional FasT-Fix device was then inserted without difficulty in each case. No case of postoperative extra-articular or intra-articular complications was encountered. The FasT-Fix suture device affords an all-inside method of meniscal repair using a strong vertical or horizontal mattress suture configuration and appears to be a safe and effective technique for meniscal repair for tears with at least a 2-mm peripheral rim. It has a high success rate and low complication rate and has results comparable to classic suture repair techniques. Level IV.

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Results of all-inside meniscal repair with the FasT-Fix meniscal repair system.

Michael Hantes, Olaf Lorbach, Elias S Kotsovolos … (2005)

The goal of this prospective study was to evaluate the results of arthroscopic meniscal repair using the FasT-Fix repair system. Prospective case series. Sixty-one meniscal repairs with the FasT-Fix meniscal repair system in 58 patients with a mean age of 32.6 years were performed between 2001 and 2002. Concurrent anterior cruciate ligament reconstruction was performed in 36 patients (62%). All tears were longitudinal and located in the red/red or red/white zone. Criteria for clinical success included absence of joint-line tenderness, locking, swelling, and a negative McMurray test. Clinical evaluation also included the Tegner and Lysholm knee scores, and KT-1000 arthrometry. In addition, all patients were evaluated preoperatively with magnetic resonance imaging. The average follow-up was 18 months (range, 14 to 28 months). Six of 61 repaired menisci (9.8%) were considered failures according to our criteria. Therefore, the success rate was 90.2%. Time required for meniscal repair averaged 11 minutes. Postoperatively, the majority of the patients had no restrictions in sports activities. The mean Lysholm significantly improved from 43.6 preoperatively to 87.5 postoperatively (P < .001). Fifty-one patients (88%) had an excellent or good result according to the Lysholm knee score. Four patients had a restriction of knee joint motion postoperatively, and an arthroscopic arthrolysis was performed in 1 of them. Analysis showed that age, length of tear, simultaneous anterior cruciate ligament reconstruction, chronicity of injury, and location of tear did not affect the clinical outcome. Our results show that arthroscopic meniscal repair with the FasT-Fix repair system provided a high rate of meniscus healing and appeared to be safe and effective in this group of patients. Level IV, therapeutic study, case series (no control group).

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Author and article information

Journal

Journal ID (nlm-ta): Vet Rec Open

Journal ID (iso-abbrev): Vet Rec Open

Journal ID (hwp): vetreco

Journal ID (publisher-id): vetreco

Title: Veterinary Record Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2052-6113

Publication date Collection: 2015

Publication date (Electronic): 27 July 2015

Volume: 2

Issue: 1

Electronic Location Identifier: e000125

Affiliations

[1 ]Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, University of Ghent, 133 Salisburylaan, Merelbeke, 9820, Belgium

[2 ]Tiergesundheitszentrum Gruβendorf Tierärztliche Klinik für Kleintiere, 2 Wiechmanns Eck 2, Bramsche, 49565, Germany

[3 ]Veterinary Centre Malpertuus, 2A Leenstraat, Heusden, 9070, Belgium

Author notes

[Correspondence to ] Adriaan M. Kitshoff; adriaan.kitshoff@ 123456ugent.be

Article

Publisher ID: vetreco-2015-000125

DOI: 10.1136/vetreco-2015-000125

PMC ID: 4567165

SO-VID: ab31ce08-b903-4a86-bf5d-5a9053d888ce

License:

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

History

Date received : 2 February 2015

Date revision received : 17 June 2015

Date accepted : 29 June 2015

Intralaryngeal thyroarytaenoid lateralisation using the Fast-Fix 360 system: a canine cadaveric study

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Abstract

Introduction

Aims and objectives

Materials and methods

Results

Conclusion

Related collections

Genome Engineering using CRISPR

Most cited references 19

Bacterial adherence to surgical sutures. A possible factor in suture induced infection.

Meniscal repair using the FasT-Fix all-inside meniscal repair device.

Results of all-inside meniscal repair with the FasT-Fix meniscal repair system.

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