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Biomedical subjects

Gary Y Shaw

Publications and source records attributed to Gary Y Shaw.

4 recordsLinked to original sources
PubMed2006

Predictors of laryngeal complications in patients implanted with the Cyberonics vagal nerve stimulator.

OBJECTIVES: Since its approval by the US Food and Drug Administration in 1997 for management of medically refractory seizures, more than 35,000 patients have been implanted with the Cyberonics vagal nerve stimulator. Preliminary reports described transient vocal changes in the majority of subjects, which were thought to be short-term. However, these reports were for the most part based upon perceptual evaluations by the subjects themselves. Later reports described possibly more permanent recurrent laryngeal nerve injury and recommended measuring the nerve diameter to use the safest spiral cuff electrode. To date, no study has systematically evaluated vocal fold mobility in subjects before and after implantation. The objectives of this study were to determine the true incidence of both short- and long-term recurrent laryngeal nerve injuries and determine whether there are any potential indicators to predict in which patients long-term nerve deficits may develop. METHODS: Thirteen subjects underwent preimplantation laryngeal electromyography, videolaryngoscopy, measurement of the maximum phonation time, Voice Handicap Index determination, and Consensus Auditory-Perceptual Evaluation of Voice. Two weeks after implantation, all subjects underwent videolaryngoscopy. Three months after implantation and activation of the device, all subjects were reevaluated. RESULTS: Six of the 13 subjects had significant vocal fold mobility abnormalities at 2 weeks. Significant electromyographic abnormalities were detected before implantation in 5 subjects. All 5 of these subjects, at 3 months after implantation, had prolonged left vocal fold paresis. CONCLUSIONS: The authors conclude that perioperative vocal fold paresis occurs in approximately 50% of subjects. Further, laryngeal electromyography performed before implantation of the vagal nerve stimulator is a statistically significant predictor (p < .05) of which patients may be at risk for extended vocal fold abnormalities. Possible explanations for this phenomenon are offered. Surgical modifications to limit vagal nerve injury are offered.

Adult↗
PubMed2004

Tonsillectomy using the Colorado microdissection needle: a prospective series and comparative technique review.

Tonsillectomy remains one of the most common surgical procedures performed worldwide. Recent advancements in equipment technology have ushered in several new tonsillectomy techniques. Among these is the Colorado tip electromicrodissection needle. In this report, we describe the technical aspects of this modality and report our results in a prospective study of 12 adults and 13 children. We then compare our results with several published series using a variety of techniques. We found tonsillectomy using the electromicrodissection needle compares most favorably in all criteria examined, including operative and perioperative blood loss, perioperative pain, return to regular diet, and cost. We conclude that electromicrodissection tonsillectomy is an excellent option for all surgeons performing tonsillectomy.

Adolescent↗
PubMed2003

Posterior cricoarytenoid myoplasty with medialization thyroplasty in the management of refractory abductor spasmodic dysphonia.

Of the approximately 100,000 Americans with primary (idiopathic) laryngeal dystonia, 10% to 15% are thought to havethe abductor form. Botulinum A toxin injected into the posterior cricoarytenoid muscle and/or cricothyroid muscle has been employed as the "gold standard" for therapeutic management; however, successful results are significantly less frequent than with injections for the adductor form. This report describes a new phonosurgical procedure, posterior cricoarytenoid myoplasty with medialization thyroplasty, designed for these refractory patients. Posterior cricoarytenoid myoplasty with medialization thyroplasty has been performed on 3 patients with abductor laryngeal dystonia. All patients had failed at least 5 previous botulinum A injections to the posterior cricoarytenoid and cricothyroid muscles. All patients underwent preoperative and 3 postoperative (2 weeks, 3 months, and 1 year) phonatory analyses. Analysis consisted of recording an aloud reading of a standard passage while a blinded trained speech pathologist counted prolonged voiceless consonants. The patients also completed a satisfaction survey at 1 year. The results demonstrated significant, long-lasting, uniform reduction in breathy breaks in all subjects. The participants all judged their symptoms as greatly improved. Bilateral procedures may be necessary, but should be staged to prevent possible airway compromise. When applied appropriately, posterior cricoarytenoid myoplasty with medialization thyroplasty is a viable tool in the management of refractory abductor laryngeal dystonia.

Adult↗