Effect of cricoarytenoid joint preservation and suture tension on arytenoid lateralization

The objective of this experimental study was to evaluate the effects of cricoarytenoid (CA) joint preservation versus disarticulation on rima glottidis (RG) area with the epiglottis open and closed under both low and high suture tension. Canine cadaver larynges were used. A unilateral arytenoid lateralization (UAL) was performed with low or high suture tension and with the CA joint preserved or disarticulated. Rima glottidis area was measured with the epiglottis in an open and closed position. Results indicated that RG area was increased over baseline when UAL was performed with both low and high suture tension when the epiglottis was in an open position. High suture tension resulted in a greater increase in RG area compared to low suture tension, both when the CA was preserved and disarticulated. There was no difference in RG area when the CA was disarticulated versus preserved at either suture tension. Rima glottidis area was not significantly increased over baseline when the epiglottis was in a closed position except in the group with CA joint preservation and high suture tension. Although this study suggests that UAL can be performed with or without CA disarticulation, further studies are warranted before UAL without CA disarticulation can be recommended clinically.