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Airway complication after thyroid surgery: minimally invasive management of bilateral recurrent nerve injury.
Laryngoscope. 2000 Jan; 110(1):140-4.L

Abstract

OBJECTIVES

After bilateral vocal cord paralysis, the consequent paramedian position usually necessitates tracheostomy for at least 6 months, when the paralysis is potentially reversible. In the present study a reversible endoscopic vocal cord laterofixation procedure was used instead of tracheotomy.

STUDY DESIGN

Prospective study of 15 consecutive patients aged 33 to 73 years who suffered bilateral recurrent laryngeal nerve paralysis after thyroid surgery.

METHODS

The operation was performed endoscopically with a special endo-extralaryngeal needle carrier instrument. Two ends of a monofilament nonresorbable thread were passed above and under the posterior third of the vocal cord and knotted on the prelaryngeal muscles, permitting the creation of an abducted vocal cord position. If movement of one or both vocal cords recovered, the suture was removed. Regular spirometric measurements and radiological aspiration tests were conducted on the patients.

RESULTS

During the follow-up period of 3 to 40 months, airway stability was demonstrated in all but one patient. After the repeated lateralization procedure, this patient's breathing improved. Partial or complete vocal cord recovery was observed in eight patients. In six patients further voice improvement was achieved when the threads were removed after vocal cord medialization or recovery. Mild postoperative aspirations ceased in the first postoperative days.

CONCLUSIONS

This management approach offers an alternative to tracheostomy in the early period of paralysis, avoids terminal loss of voice quality, and provides a "one-stage" solution for permanent bilateral recurrent nerve injuries.

Authors+Show Affiliations

Department of Otorhinolaryngology, Head and Neck Surgery, Albert Szent-Györgyi Medical University, Szeged, Hungary. rovo@orl.szote.u-szeged.huNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10646730

Citation

Rovó, L, et al. "Airway Complication After Thyroid Surgery: Minimally Invasive Management of Bilateral Recurrent Nerve Injury." The Laryngoscope, vol. 110, no. 1, 2000, pp. 140-4.
Rovó L, Jóri J, Brzózka M, et al. Airway complication after thyroid surgery: minimally invasive management of bilateral recurrent nerve injury. Laryngoscope. 2000;110(1):140-4.
Rovó, L., Jóri, J., Brzózka, M., & Czigner, J. (2000). Airway complication after thyroid surgery: minimally invasive management of bilateral recurrent nerve injury. The Laryngoscope, 110(1), 140-4.
Rovó L, et al. Airway Complication After Thyroid Surgery: Minimally Invasive Management of Bilateral Recurrent Nerve Injury. Laryngoscope. 2000;110(1):140-4. PubMed PMID: 10646730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Airway complication after thyroid surgery: minimally invasive management of bilateral recurrent nerve injury. AU - Rovó,L, AU - Jóri,J, AU - Brzózka,M, AU - Czigner,J, PY - 2000/1/26/pubmed PY - 2000/1/26/medline PY - 2000/1/26/entrez SP - 140 EP - 4 JF - The Laryngoscope JO - Laryngoscope VL - 110 IS - 1 N2 - OBJECTIVES: After bilateral vocal cord paralysis, the consequent paramedian position usually necessitates tracheostomy for at least 6 months, when the paralysis is potentially reversible. In the present study a reversible endoscopic vocal cord laterofixation procedure was used instead of tracheotomy. STUDY DESIGN: Prospective study of 15 consecutive patients aged 33 to 73 years who suffered bilateral recurrent laryngeal nerve paralysis after thyroid surgery. METHODS: The operation was performed endoscopically with a special endo-extralaryngeal needle carrier instrument. Two ends of a monofilament nonresorbable thread were passed above and under the posterior third of the vocal cord and knotted on the prelaryngeal muscles, permitting the creation of an abducted vocal cord position. If movement of one or both vocal cords recovered, the suture was removed. Regular spirometric measurements and radiological aspiration tests were conducted on the patients. RESULTS: During the follow-up period of 3 to 40 months, airway stability was demonstrated in all but one patient. After the repeated lateralization procedure, this patient's breathing improved. Partial or complete vocal cord recovery was observed in eight patients. In six patients further voice improvement was achieved when the threads were removed after vocal cord medialization or recovery. Mild postoperative aspirations ceased in the first postoperative days. CONCLUSIONS: This management approach offers an alternative to tracheostomy in the early period of paralysis, avoids terminal loss of voice quality, and provides a "one-stage" solution for permanent bilateral recurrent nerve injuries. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/10646730/Airway_complication_after_thyroid_surgery:_minimally_invasive_management_of_bilateral_recurrent_nerve_injury_ L2 - https://doi.org/10.1097/00005537-200001000-00025 DB - PRIME DP - Unbound Medicine ER -