Vytenis Grybauskas
University of Illinois at Chicago
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Featured researches published by Vytenis Grybauskas.
Laryngoscope | 1986
Michael Friedman; Dean M. Toriumi; Vytenis Grybauskas; Arthur Katz
The anomalous position of a nonrecurrent laryngeal nerve predisposes the nerve to injury during thyroidectomy and to compression by a thyroid mass. We present three cases in which a seemingly benign thyroid mass traumatized a nonrecurrent laryngeal nerve resulting in either vocal cord paralysis or a vague pressure sensation over the larynx. Some of these patients feel as if they need to clear a foreign body and present with a chronic cough. Normally the nerve is protected from thyroid masses as it passes through the tracheoesophageal groove. In all three patients, surgical excision of the thyroid mass and release of the nerve resulted in recovery of the nerve and resolution of the symptoms. We have found that small, benign, or otherwise asymptomatic lesions of the thyroid gland have a greater tendency to cause vocal cord paralysis in patients with nonrecurrent laryngeal nerves. The surgeon must always be aware of the possibility of the presence of a nonrecurrent laryngeal nerve.
Laryngoscope | 1988
Michael Friedman; Dean M. Toriumi; Ruth Owens; Vytenis Grybauskas
Subglottic or tracheal reconstruction may be required in cases of subglottic stenosis, invasive thyroid carcinoma, or trauma. The sternocleidomastoid myoperiosteal flap uses clavicular periosteum on a muscle pedicle to provide vascularity. Clavicular periosteum is fibrous, durable, and will conform to the shape of the trachea, forming bone to provide stability to the airway. The procedure is relatively simple and involves single‐staged reconstruction.
Annals of Otology, Rhinology, and Laryngology | 1989
Michael Friedman; Vytenis Grybauskas; Dean M. Toriumi; Edward L. Applebaum
Spastic dysphonia, a rare speech disorder, is characterized by strained phonation with excessively adducted vocal cords. Recurrent laryngeal nerve section, botulinum toxin injection into the vocalis-thyroarytenoid muscle complex, and other techniques have been used to treat this disorder. We have used percutaneous electrical stimulation of the recurrent laryngeal nerve with good results. Previous dog studies demonstrated the relative safety of an implantable recurrent laryngeal nerve stimulator. In this study, we directly stimulated the recurrent laryngeal nerve and vagus nerve in a dog without change in cardiorespiratory status. A Medtronic peripheral nerve stimulator was implanted in a patient with abductor spastic dysphonia. The cuff electrode was positioned around the recurrent laryngeal nerve and stimulation resulted in improvement in her voice. Extensive cardiopulmonary monitoring did not reveal any adverse response to stimulation and there was no discomfort to the patient. On the basis of the good results of this preliminary study, further study with long-term follow-up is under way.
Annals of Otology, Rhinology, and Laryngology | 1987
Michael Friedman; Vytenis Grybauskas; Emanuel M. Skolnik; Dean M. Toriumi; Thomas Chilis
Reconstruction of the subglottis is usually required after resection of cricoid cartilage or tracheal tissue in cases of trauma, subglottic stenosis, or invasive thyroid carcinoma. There are multiple techniques available for reconstruction of the subglottic larynx, but most of them have a high rate of complications or graft failure. We have found the sternocleidomastoid myoperiosteal flap to be an ideal means of reconstruction. In an experimental study, we performed subglottic reconstruction using the sternomastoid myoperiosteal flap on 15 mongrel dogs to determine the presence of bone formation versus calcified fibrous scar. Radiologic studies suggested apparent metaplastic bone formation at the graft site, and histologic studies confirmed this. Functionally, 12 dogs had stable airways without stridor or subglottic narrowing. Three dogs died of complications. With successful reconstruction of large defects in the canine subglottis, attempts to repair large subglottic and tracheal defects in the human are feasible.
Annals of Otology, Rhinology, and Laryngology | 1987
Michael Friedman; Vytenis Grybauskas; Dean M. Toriumi; Edward L. Applebaum
Spastic dysphonia is a disorder characterized by strained, constricted phonation with excessively adducted vocal cords. Despite initial success with recurrent laryngeal nerve section, the search for other treatment continues. Our clinical study involved inserting a needle electrode percutaneously into the region of the recurrent laryngeal nerve in five patients with spastic dysphonia. Electrical stimulation resulted in dramatic improvement in three patients and minimal improvement in two. Our experimental study was designed to create an animal model for an implantable nerve stimulator to be used on a long-term basis. A Medtronic spinal cord stimulation system was implanted into a dog, and a cuff electrode was positioned around the recurrent laryngeal nerve. Vocal cord position could be altered by varying the stimulus frequency. Long-term stimulation of the recurrent laryngeal nerve was relatively safe and effective. Eventually, we plan to implant nerve stimulators into spastic dysphonia patients who respond well to percutaneous stimulation.
Operative Techniques in Otolaryngology-head and Neck Surgery | 1990
Michael Friedman; Vytenis Grybauskas; David Chang
The superiorly based platysma myocutaneous flap has been previously described and used extensively for repair of oral defects. This flap had limited usefulness for hypopharyngeal reconstruction for two reasons: tumor resection that necessitates ligation of the facial vein and artery renders this flap highly unreliable; and the superiorly based flap would require a very long pedicle for hypopharyngeal reconstruction. The inferiorly based flap provides a reliable thin flap that is ideal for hypopharyngeal reconstruction. It has been used in 10 patients after tumor resection or after extensive lye burns. Its use, however, is limited if an ipsilateral radical neck dissection is required.
Archives of Otolaryngology-head & Neck Surgery | 1984
Michael Friedman; Vicki K. Shelton; Mahmood F. Mafee; Phillipe Bellity; Vytenis Grybauskas; Emanuel M. Skolnik
Head & Neck Surgery | 2006
Michael Friedman; Vytenis Grybauskas; Dean M. Toriumi; Allen Kaplan; Allen M. Seiden
Archives of Otolaryngology-head & Neck Surgery | 1986
Michael Friedman; Vytenis Grybauskas; Emanuel M. Skolnik; Arthur Katz; Thomas Chilis; Dean M. Toriumi
Archives of Otolaryngology-head & Neck Surgery | 1987
Michael Friedman; Dean M. Toriumi; Vytenis Grybauskas