Changes in Rima Glottidis Area and Lack of Laryngeal Epiglottic–Glottic Seal After Unilateral Cricoarytenoid Lateralization Ex Vivo

ObjectiveTo evaluate variation in rima glottidis (RG) area and lack of epiglottic–glottic seal (LEGS) of the canine larynx associated with different suture anchor points in the arytenoid and cricoid cartilages, dissection of the cricoarytenoid joint capsule, section of the interarytenoid band, and disarticulation of the cricothyroid joint.Study DesignExperimental study.AnimalsCadaveric canine larynges (n = 18).MethodsLarynges were assigned to 2 groups: group 1 = intact cricothyroid articulation and group 2 = cricothyroid articulation sharply sectioned. In each group, the arytenoid cartilage was lateralized successively as follows: (a) intact cricoarytenoid articulation, (b) cricoarytenoid articulation sharply sectioned, and (c) division of the interarytenoid band. Each variation was performed initially with the suture passed dorsally into the cricoid cartilage then with the suture passed laterally. Each time, the increase of rima glottis area (%) and the LEGS (mm2) were measured.ResultsRima glottis area (RGA): when the suture was placed dorsally, division of the interarytenoid band resulted in a significant increase in RGA compared with groups with an intact band. Laryngeal distortion: when the suture through the cricoid cartilage was dorsal, LEGS increased with section of the cricothyroid articulation, dissection of cricoarytenoid articulation, and division of the interarytenoid band.ConclusionUnilateral arytenoid lateralization results in some degree of LEGS with a misalignment of the epiglottis over the RG. Our results revealed that the optimal RGA associated with the minimal LEGS was obtained with dorsal placement of a cricoarytenoid suture when the cricothyroid joint and the interarytenoid band were intact.