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DOI: 10.1055/s-0028-1119503
© Georg Thieme Verlag KG Stuttgart · New York
Larynx: Implantate und Stents
Larynx: Implants and StentsPublikationsverlauf
Publikationsdatum:
07. April 2009 (online)
![](https://www.thieme-connect.de/media/lro/2009S01/lookinside/thumbnails/10.1055-s-0028-1119503-1.jpg)
Zusammenfassung
Für die Implantation in den menschlichen Kehlkopf stehen zahlreiche Produkte zur Verfügung. Manche sind nur für einen vorübergehenden Verbleib vorgesehen, wie etwa die laryngealen Stents. Im engeren Sinn handelt es sich jedoch nur dann um ein medizinisches Implantat, wenn a priori keine Entfernung vorgesehen ist. In der Laryngologie spielen Implantate zur Behandlung einer glottischen Insuffizienz auf dem Boden eines einseitigen Stimmlippenstillstands die größte Rolle. Zu diesem Zweck stehen 2 unterschiedliche Formen von Implantaten zur Verfügung: Implantate im eigentlichen Sinn, die aus solidem Material gefertigt sind und über einen Zugang von außen in den paraglottischen Raum eingebracht werden, um die stillstehende Stimmlippe in eine mehr mediane Position zu verlagern (Thyroplastik). In dieser Übersicht werden mehrere Produkte vorgestellt, die zu diesem Zweck entwickelt wurden. Zum anderen stehen verschiedene Substanzen zur Verfügung, die auf endoskopischem Wege in die immobile Stimmlippe injiziert werden können, um die glottische Insuffizienz zu verbessern (Augmentation). Der Übergang zu den soliden Implantaten ist fließend, weil manche dieser Substanzen korpuskulär und hochviskös sind, sodass sie analog zu den soliden Implantaten im lateralen paraglottischen Raum deponiert werden („injectable implants”). Stents werden im Larynx und im laryngotrachealen Übergang in erster Linie in der postoperativen Phase nach rekonstruktiven Eingriffen eingesetzt. Die verschiedenen Produkte, die zu diesem Zweck auf dem Markt sind, werden ausführlich dargestellt.
Abstract
There is a wide variety of devices and materials to be implanted into the human larynx. Some are intended to remain only for a period of time, like laryngeal stents. If removal is not intended the device meets the definition for a medical implant. The majority of implants is used for the treatment of unilateral vocal fold immobility. There a 2 types of implants serving this purpose: Implants in a stricter sense are devices of solid material, which are brought into the paraglottic space through a window in the laryngeal framework (medialization thyroplasty). Several different products are presented in this review. In contrast, there are different substances available for endoscopic injection into the paralyzed vocal fold (injection laryngoplasty). Since some of these substances show a corpuscular consistency and a high viscosity they need to be deposited into the lateral paraglottic space. Therefore, the term „injectable implants” has been coined for these materials. The different substances available are discussed in detail in this review.
Laryngeal stents are primarily used in the early postoperative phase after open reconstruction of the larynx. The different devices available on the market are described with their specific characteristics and intended use.
Schlüsselwörter
Thyroplastik - Stimmlippenaugmentation - laryngotracheale Stenose - laryngotracheale Rekonstruktion - Atemwegsstenose - Stimmverbesserung
Key words
thyroplasty - laryngoplasty - vocal fold augmentation - laryngeal stenosis - laryngotracheal reconstruction - laryngeal framework surgery
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Prof. Dr. med. Christian Sittel
Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische
Operationen
Klinikum Stuttgart – Katharinenhospital
Kriegsbergstraße 60
70174 Stuttgart
eMail: c.sittel@klinikum-stuttgart.de