Abstract #490, Date 2/16/99, Session Q, Podium , 2:00p

Effect of adducting suture placement on resultant arytenoid and vocal cord position in the human cadaver larynx

*I. Iwanow, P. Rigby, A. Alexander, P. Friedlander (LSU-New Orleans)

Vocal function following vocal cord paralysis can be substantially improved following arytenoid adduction. One potential complication of arytenoid adduction is vocal cord shortening with resultant bowing. Using ten human cadaver larynges, we investigated the impact of adducting suture placement on resultant vocal cord and arytenoid position. Five larynges with adducting sutures placed at the posterior aspect of the arytenoid joint capsule were compared with five larynges with adducting sutures placed through the muscular process. Vocal cord length, interarytenoid distance, and posterior gap were measured pre and postoperatively. We found that placement of the suture posteriorly resulted in less shortening on average of the vocal cord (0.1mm) with visibly less bowing when compared with the adduction suture placed through the muscular process (1.6mm) as described by Issiki (Archives of Otolaryngol Vol 104, pp 555-558, Oct. 1978). Interarytenoid distance was reduced to a greater degree with posteriorly placed sutures (1.9mm vs. 1.3mm) Thus, a more posterior placement of the adducting suture may result in greater postoperative cord tension and potentially improved voice quality.