Chirurgia dróg oddechowych. Syndrom brachycefaliczny – cz. III
Surgical technique for an elongated and hyperplastic soft palate
For patient with a severe hyperplasia of the soft palate, techniques resulting in more extensive shortening of the soft palate have been described (Brdecka et al., 2008; Findji and Dupré, 2008; Findji and Dupré, 2009; Dunié-Mérigot et al., 2010). A folded flap palatoplasty has been developed to correct both the excessive length and excessive thickness of the soft palate (Findji and Dupré, 2008; Findji and Dupré, 2009).
In this technique, the soft palate is made thinner by excision of a portion of its oropharyngeal mucosa and soft tissues and shorter by being folded on itself. These techniques leave only a few centimeters of soft palate by using the cranial commissure of the tonsillar crypt as a landmark for simple palatal resection (Brdecka et al., 2008; Dunié-Mérigot et al., 2010) or by folding the soft palate on itself enough for the caudal opening of the nasopharynx to be directly visible transorally (Dupré and Findji and Poncet, 2005). Postoperative adverse effects or pharyngonasal regurgitation have not been observed with this technique (Brdecka et al., 2008; Findji and Dupré, 2008; Findji and Dupré, 2009; Dunié-Mérigot et al., 2010).
Laryngeal diseases
Everted laryngeal ventricles (often named saccules, or laryngoceles), are formed by eversion of the mucosa of the laryngeal ventricles. The everted saccules may obstruct the ventral half of the rima glottidis. In the past, their excision has been recommended as a routine procedure when they are found (Harvey and Venker-von Haagan, 1975; Harvey, 1983; Aron and Crowe, 1985; Hendricks, 1992; Hobson, 1995; Lorinson et al., 1997; Hedlund, 1998; Koch et al., 2003; Torrez and Hunt, 2006).
It is performed via an oral approach using electrocautery, scissors, tonsil snares or laryngeal biopsy cup forceps (Wykes, 1991; Hedlund, 1998). Nowadays as these procedures can lead to scar formation and laryngeal webbing, removal of ELS is only r...
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