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Nucleotide sequencing analysis of the 146-kilobase segment around the IkBL and MICA genes at the centromeric end of the HLA class I region
Authors:T Shiina  G Tamiya  A Oka  T Yamagata  N Yamagata  E Kikkawa  K Goto  N Mizuki  K Watanabe  Y Fukuzumi  S Taguchi  C Sugawara  A Ono  L Chen  M Yamazaki  H Tashiro  A Ando  T Ikemura  M Kimura  H Inoko
Affiliation:Department of Otolaryngology-Head and Neck Surgery, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts, USA.
Abstract:The biomechanics of medialization laryngoplasty are not well understood. An excised canine larynx model was used to test the effects of various sized silicon implants. The vocal fold length, position, and tension were measured. Medialization laryngoplasty did not affect vocal fold length. At the mid-membranous vocal fold, larger shims resulted in greater medialization and tension. Medialization laryngoplasty neither medialized nor stiffened the vocal process to resist lateralizing forces. We conclude that medialization laryngoplasty provides bulk and support for defects of the membranous region of the vocal fold, but does not appear to close a posterior glottal gap. The selection of a surgical procedure to treat glottal incompetence should take into account the unique biomechanical properties of the anterior (membranous vocal folds) and posterior (cartilaginous portion) glottis.
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