Microendoscopy of Reinke's Space (MERS)

Microendoscopy of Reinke's space is a surgical procedure under development. It is an extension of the 'minithyrotomy' approach to Reinke's space developed by Steve Gray and successfully employed by Randy Paniello and others to treat disorders of Reinke's space (1,2,3). Preliminary human cadaver work has been published (4) and presented (5) identifying the utility of high resolution microendoscopes to image and direct dissection of Reinke's space through a percutaneous, trans-cricothyroid membrane puncture.

The light from the microendoscopes is visible through the vocal fold in the images below. A zero degree telescope was used to video-image the vocal folds as they would be seen through conventional microlaryngoscopy concurrently with the percutaneous MERS in this human cadaver larynx.

The video below identifies this approach employing a pig larynx to demonstrate dissection within Reinke's space.

VIDEO

References

1.Wexler DB, Jiang J, Gray SD, Titze IR. Phonosurgical studies: fat-graft reconstruction of injured canine vocal cords. Ann Otol Rhinol Laryngol. 1989;98(9):668-73

2.Gray SD, Bielamowicz SA, Titze IR, Dove H, Ludlow C. Experimental approaches to vocal fold alteration: introduction to the minithyrotomy. Ann Otol Rhinol Laryngol. 1999;108(1):1-9

3. Paniello RC, Sulica L, Khosla SM, Smith ME. Clinical experience with Gray's minithyrotomy procedure. Ann Otol Rhinol Laryngol. 2008;117(6):437-442

4.  Hoffman HT, Bock JM, Karnell LH, Ahlrichs-Hanson J. Microendoscopy of Reinke's space. Ann Otol Rhinol Laryngol., 2008 Jul:117(7):510-4; discussion 515-6.

5. Hoffman HT, Bock JM, Askeland RW, Ahlrichs-Hanson JS, and Van Daele DJ: Histologic Evaluation of Microendoscopy of Reinke's Space in Cadaveric Human Larynges  presented at the Middle/Sourther Section of the Triologic  Bonita Spring Florida   Saturday am January 10, 2009