Vocal Fold Prosthesis for Laryngeal Web Prevention
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Solution Overview
Problem
Existing stents and keels used to prevent laryngeal web formation after surgical procedures often fail to prevent regrowth, causing impaired vocal quality, hoarseness, and airway obstruction, and require external fixation and complete resection, which can interfere with speech and breathing.
Innovation Solution
A prosthesis with a corpus and flanges is inserted through a surgically created hole in the laryngeal web, secured with a suture, allowing air passage and speech while in place, and is designed to reduce regrowth by maintaining a sharp anterior commissure and allowing healing without obstructing the airway.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional stents or keels are placed between vocal folds to prevent laryngeal web formation, then the vocal folds are kept separated during healing, but the stents interfere with swallowing and speech, and often fail to prevent regrowth
Solution Approach 1:
The prosthesis is divided into distinct functional segments: a corpus portion that contacts the vocal folds to maintain separation, and flange portions that extend outward to provide anchoring without interfering with the airway. This segmentation allows the device to fulfill its preventive function while minimizing interference with swallowing and speech.
Solution Approach 2:
The prosthesis extends from the two-dimensional plane between the vocal folds into the third dimension by incorporating flange portions that protrude laterally. This dimensional extension provides additional anchoring surface area and prevents device migration without requiring larger dimensions in the constraining direction, thereby maintaining airway patency.
2Reliability
If larger stents are used to maintain vocal fold separation, then prevention of web regrowth is improved, but the patient cannot speak or breathe normally while the stent is in place
Solution Approach 1:
The prosthesis applies separation force locally at the vocal fold contact point through the corpus portion, while the flange portions are designed with reduced cross-sectional area to minimize airway obstruction. This localized application of the separation function allows effective prevention of web formation while preserving normal speech and breathing functions.
3Reliability
If complete resection of laryngeal web is performed, then the web is removed entirely, but external fixation with sutures is required and the procedure becomes more complex
Solution Approach 1:
The prosthesis serves as an intermediary device that facilitates complete web resection by providing internal support during healing. Instead of requiring external sutures through the neck, the prosthesis is secured internally, eliminating the need for external fixation and reducing procedural complexity.
Data Source
AI summary
Typically, surgical intervention is required to remedy abnormalities of the vocal cords. However, surgical intervention often causes a laryngeal web, or glottic web, to form which impairs the sound quality of the vocal cords. The prosthesis and methods of the invention effectively eliminate regrowth of a laryngeal web after surgery over all other prior art devices and methodologies. During the operative procedure, the prosthesis may be inserted through a surgically created hole in a laryngeal web allowing a laryngeal bridge to assist in holding the prosthesis in position. Following surgery, after the vocal cords heal, the prosthesis may then be removed, and the laryngeal bridge also removed. In the case of an anterior procedure, the prosthesis produces a sharp anterior commissure without any glottic web. The prosthesis and method greatly reduce the recurrence of a laryngeal web.