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McNamara et al: Description and evaluation of a novel transoral endoscopic arytenopexy in canine cadavers
Veterinary Surgery 7, 2022

🔍 Key Findings

  • TEA significantly increased the rima glottis area (RGA) from a mean of 0.52 cm³ to 0.78 cm³ (p < .0001)
  • Mean RGA increased by 157%, equivalent to an 84% estimated decrease in airway resistance
  • LEGS (laryngeal epiglottic-glottic seal) remained intact in all cadavers post-procedure, indicating maintained airway protection
  • TEA was technically feasible in all 15 cadaveric dogs using a custom endoscopic gag port (EGP)
  • TEA avoids cervical dissection, potentially reducing surgical trauma and risks compared to UAL (unilateral arytenoid lateralization)
  • Compared to UAL, TEA showed slightly less RGA increase, but greater LEGS preservation, potentially reducing aspiration risk
  • No cartilage was included in sutures; arytenopexy involved soft tissue fixation to pharyngeal wall across the piriform recess
  • Cadaver model limitations include inability to assess functional outcomes like swallowing and respiratory motion impact

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← Articles

McNamara et al: Description and evaluation of a novel transoral endoscopic arytenopexy in canine cadavers
Veterinary Surgery 7, 2022

🔍 Key Findings

  • TEA significantly increased the rima glottis area (RGA) from a mean of 0.52 cm³ to 0.78 cm³ (p < .0001)
  • Mean RGA increased by 157%, equivalent to an 84% estimated decrease in airway resistance
  • LEGS (laryngeal epiglottic-glottic seal) remained intact in all cadavers post-procedure, indicating maintained airway protection
  • TEA was technically feasible in all 15 cadaveric dogs using a custom endoscopic gag port (EGP)
  • TEA avoids cervical dissection, potentially reducing surgical trauma and risks compared to UAL (unilateral arytenoid lateralization)
  • Compared to UAL, TEA showed slightly less RGA increase, but greater LEGS preservation, potentially reducing aspiration risk
  • No cartilage was included in sutures; arytenopexy involved soft tissue fixation to pharyngeal wall across the piriform recess
  • Cadaver model limitations include inability to assess functional outcomes like swallowing and respiratory motion impact

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Multiple Choice Questions on this study

In McNamara 2022 et al., on transoral endoscopic arytenopexy, what was the mean percentage increase in rima glottis area (RGA) following the TEA procedure?

A. 84%
B. 112%
C. 157%
D. 180%
E. 192%

Answer: 157%

Explanation: The study found a mean 157% increase in RGA following TEA.
In McNamara 2022 et al., on transoral endoscopic arytenopexy, what was the primary clinical advantage of the TEA technique compared to traditional unilateral arytenoid lateralization (UAL)?

A. It allowed inclusion of cartilage for better fixation
B. It required no specialized instruments
C. It produced a greater RGA increase
D. It preserved the LEGS in all cases
E. It allowed bilateral fixation without aspiration risk

Answer: It preserved the LEGS in all cases

Explanation: TEA preserved the laryngeal epiglottic-glottic seal (LEGS) in 100% of cases, whereas UAL often disrupts it.
In McNamara 2022 et al., on transoral endoscopic arytenopexy, which of the following best describes the tissue fixation performed during TEA?

A. Suture fixation of arytenoid cartilage to thyroid cartilage
B. Inclusion of cartilage for rigid support
C. Suturing of arytenoid soft tissue to piriform recess
D. Suturing of arytenoid to the cricoid cartilage
E. Use of absorbable suture for dynamic tension

Answer: Suturing of arytenoid soft tissue to piriform recess

Explanation: TEA involved suturing arytenoid soft tissues (not cartilage) to pharyngeal wall across the piriform recess.
In McNamara 2022 et al., on transoral endoscopic arytenopexy, what was the estimated reduction in airway resistance based on the observed RGA increase?

A. 34%
B. 52%
C. 67%
D. 84%
E. 95%

Answer: 84%

Explanation: The 157% increase in RGA corresponded to an estimated 84% decrease in airway resistance using the Hagen-Poiseuille equation.
In McNamara 2022 et al., on transoral endoscopic arytenopexy, what limitation of the cadaver model was specifically mentioned regarding functional outcomes?

A. Inability to control suture tension
B. No comparison group with UAL
C. Unreliable imaging calibration
D. No data on swallowing and respiratory motion
E. No method to verify LEGS

Answer: No data on swallowing and respiratory motion

Explanation: The study notes cadaver models can't assess dynamic processes like swallowing or breathing, limiting real-world outcome prediction.

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