ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Papillomatosis Tissue Utilized to Correct Anterior Commissure Webbing

by Ed Susman • May 1, 2007

  • Tweet
  • Email
Print-Friendly Version

MARCO ISLAND, FL-Doctors said they have successfully corrected anterior commissure web formation in papilloma patients with a unique endoscopic microflap laryngoplasty that actually makes use of excess tissue produced in patients with recurrent respiratory papillomatosis.

You Might Also Like

  • Laryngeal Distribution of Recurrent Respiratory Papillomatosis
  • Adjuvant Therapies May Increase Time Between Surgeries for Recurrent Respiratory Papillomatosis
  • Suspect Adult Respiratory Papillomatosis with Recurrent Hoarseness after Surgery
  • Prevalence of Dysplasia with Recurrent Respiratory Papillomatosis Is High
Explore This Issue
May 2007

In an oral presentation at the combined section meeting of the Triological Society here, Lee Akst, MD, Assistant Professor of Otolaryngology at Loyola University Stritch School of Medicine in Maywood, IL, demonstrated and described treatment of five patients who developed the webbing.

Endoscopic microflap layngoplasty utilizing redundant papillomatous epithelium is an effective strategy for lengthening the glottal aperture and enhancing anterior glottic-subglottal exposure for future recurrent respiratory papillomatosis treatment, Dr. Akst said. This approach combines precise cold instrument phonomicrosurgical techniques to manage the web while using an angiolytic laser to precisely involute the diseased epithelium.

Anterior commissure webbing occurs in approximately 13.6 percent to 42 percent of patients with recurrent respiratory papillomatosis as documented in several studies, Dr. Akst said. The incidence of webbing occurs despite the recommendations of many surgeons to treat anterior commissure disease very carefully.

Patients with recurrent respiratory papillomatosis of the glottis may develop an anterior commissure web after repeated treatment with injudicious use of any modality. These synechia can obscure disease on the undersurface of the web and more caudally in the subglottis, he explained.

Dr. Akst said that some of the webs that form can be large enough to affect the airway. At any time they can hide disease in the anterior subcordal and subglottic areas and that can limit your ability to manage these patients in the office, he said.

Dr. Akst suggested that previous surgical solutions to the problem, such as endoscopic keel placement or transcervical laryngofissure techniques, do not seem to work well in the presence of papillomatosis.

Mucosal advancement flaps works well for congenital webs, but it is more difficult when the epithelium is adherent to scar tissue, he said. It is difficult to suture, particularly when anterior commissure exposure is limited and the treatment has not been described in conjunction with management of papilloma.

Purpose of the Procedure

The goal of the procedure, he said, is to restore vocal fold length by anterior commissure laryngoplasy in patients with recurrent respiratory papillomatosis.

Dr. Akst said that his study presents a novel endoscopic laryngoplasty technique designed to lengthen the glottal aperture and enhance exposure of the subcordal and subglottic airway. He said the procedure requires a universal modular glottiscope; a posterior cord spreader was used to provide better anterior commissure exposure during the operative microendoscopy.

Pages: 1 2 3 | Single Page

Filed Under: Articles, Clinical, Features Issue: May 2007

You Might Also Like:

  • Laryngeal Distribution of Recurrent Respiratory Papillomatosis
  • Adjuvant Therapies May Increase Time Between Surgeries for Recurrent Respiratory Papillomatosis
  • Suspect Adult Respiratory Papillomatosis with Recurrent Hoarseness after Surgery
  • Prevalence of Dysplasia with Recurrent Respiratory Papillomatosis Is High

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Weaning Patients Off of PPIs
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Did You Receive COVID-19 Relief? Here Are Reporting Considerations for 2021
    • Otolaryngology Experts Share Best Practices in Five Areas
    • How Climate Change May Be Affecting Sleep Patterns for Adults and Children
    • Laryngologists Discuss Tough Tracheostomy Choices During COVID-19 Era
    • Head and Neck Cancer: Experts Discuss How to Improve Surgery Quality and Value

Polls

Did you receive funding from the CARES Act or Paycheck Protection Program?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.