Montgomery thyroplasty implant system.

A standardized system has been developed to treat unilateral vocal cord paralysis by medialization of the paralyzed cord. The Montgomery Thyroplasty Implant System consists of a medialization implant, measuring devices, and surgical instruments. The surgical instruments are used to locate, measure, and create a window in the thyroid lamina in which the implant is placed. The measuring devices are used to predetermine the correct implant size. There are five sizes for males (8 to 12 mm) and five for females (6 to 10 mm), with the size representing the distance of medialization. The implant consists of a firm, three-tiered base that locks the implant in the cartilage, and a soft, triangular top that serves to medialize the cord. The standardization of the base allows for revision or reversal at a later date without disturbing the window. The thyroplasty system and surgical procedures are described. Preliminary results of 176 patients who have undergone the Montgomery Thyroplasty Implant System procedure are presented.

Manual for use of Montgomery laryngeal, tracheal, and esophageal prostheses: update 1990.

This manual is designed to instruct the surgeon, the nurse, and, directly or indirectly, the patient on the updated usage of prostheses involved with reconstructive surgery of the larynx, trachea, and esophagus. The silicone tracheal Safe-T-Tube has been modified in an attempt to prevent its being displaced posteriorly into the trachea. The silicone tracheal cannula can be used in place of a tracheotomy tube unless there is aspiration or positive pressure breathing is required. Its success with sleep apnea has been especially gratifying. The salivary bypass tube and the esophageal tube continue to be of use in treating fistulas, strictures, and reconstruction of the cervical esophagus. The laryngeal keel and stent are described and illustrated for use with reconstructive surgery of the larynx.

Manual for use of Montgomery laryngeal, tracheal, and esophageal prostheses.

This manual is designed to instruct the surgeon, nurse, and, directly or indirectly, the patient on the updated usage of prostheses involved with reconstructive surgery of the larynx, trachea, and esophagus. The silicone tracheal T-tube has been modified in an attempt to prevent its being displaced posteriorly into the trachea. The silicone tracheal cannula can be used in place of a tracheotomy tube unless there is aspiration or positive pressure breathing is required. Its success with sleep apnea has been especially gratifying. The salivary bypass tube and the esophageal tube continue to be of use when treating esophageal fistulas, strictures, and reconstruction of the cervical esophagus. The laryngeal keel and stent are described and illustrated for use with reconstructive laryngeal surgery.

Inverted papilloma.

Two hundred twenty-three cases of inverted papilloma seen at this institution over a 35-year period were reviewed. The number of cases steadily increased over each 5-year period. Common presenting signs and symptoms, association with carcinoma, and results of surgical and radiographic treatment are presented. The pathologic controversy surrounding this disease is discussed, and an argument is made for including all pathologic subtypes and septal, lateral wall, or sinus cases in a common clinical grouping of inverted papilloma. Lateral rhinotomy was found to be associated with fewer recurrences and a better probability of cure than lesser procedures and is recommended as the standard surgical therapy. Radiotherapy was found to be a useful and effective adjunct in cases associated with malignancy or for multiply recurrent and inoperable benign inverted papillomas. Lifelong follow-up is urged.