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Contact laser surgery in treatment of vocal fold paralysis.
Acta Otorhinolaryngol Ital. 2003 Feb; 23(1):33-7.AO

Abstract

Vocal fold paralysis is a pathological condition characterised by varying degrees of respiratory distress in relation to the degree of glottic stenosis. Dyspnoea may be present even when resting and may even require emergency tracheotomy. Frequently, the patient arrives for attention after the onset of exertional dyspnoea associated with a certain degree of dysphonia. The causes may be central or peripheral, more commonly iatrogenic following thyroid or tracheal surgery or secondary to injury. The aim of all surgical techniques used in the treatment of vocal fold paralysis is to restore a lumen sufficient to guarantee adequate breathing through the natural airway, without the patient having to permanently maintain the tracheotomy tube, while preserving acceptable phonatory quality. Between 1990 and 2001, at the Padua Hospital Unit of Endoscopic Airway Surgery, 48 patients (27 female, 21 male) were treated for respiratory distress secondary to vocal fold paralysis. At the beginning of this experience, 7 patients underwent arytenoidectomy with the Ossoff technique. In 34 cases, a modified Dennis-Kashima posterior cordectomy was performed. In 7 patients, since widening of the airway was necessary, cordectomy was extended to the false homolateral chord in 5 cases and to the arytenoid vocal process in another 2. In 9 patients, the operation was carried out with a Nd Yag (1064 nm) contact laser; the remaining 39 were treated with a GaArAl (810 nm) diode laser in use since 1995. Satisfactory results were obtained in all patients first treated by us and not already tracheotomised (35). In 23 cases (66%), results were considered "good" since no exertional dyspnoea occurred. In 12 patients (34%), the result was considered "sufficient" since there was no resting dyspnoea and normal everyday activity could be undertaken. Of the 13 patients already tracheotomised on arrival, 11 (85%) were decanulated on average 2 months after surgery. In conclusion, the present results show that endoscopic posterior cordectomy, performed by contact diode laser, gives reliable results, is rapid and simpler to perform than arytenoidectomy and guarantees a sufficient airway without impairing swallowing, while maintaining entirely acceptable voice quality.

Authors+Show Affiliations

Unit of Endoscopic Airway Surgery, Hospital Service of University of Padua, Italy. snarne@unipd.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12812133

Citation

Saetti, R, et al. "Contact Laser Surgery in Treatment of Vocal Fold Paralysis." Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-facciale, vol. 23, no. 1, 2003, pp. 33-7.
Saetti R, Silvestrini M, Galiotto M, et al. Contact laser surgery in treatment of vocal fold paralysis. Acta Otorhinolaryngol Ital. 2003;23(1):33-7.
Saetti, R., Silvestrini, M., Galiotto, M., Derosas, F., & Narne, S. (2003). Contact laser surgery in treatment of vocal fold paralysis. Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-facciale, 23(1), 33-7.
Saetti R, et al. Contact Laser Surgery in Treatment of Vocal Fold Paralysis. Acta Otorhinolaryngol Ital. 2003;23(1):33-7. PubMed PMID: 12812133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contact laser surgery in treatment of vocal fold paralysis. AU - Saetti,R, AU - Silvestrini,M, AU - Galiotto,M, AU - Derosas,F, AU - Narne,S, PY - 2003/6/19/pubmed PY - 2003/8/2/medline PY - 2003/6/19/entrez SP - 33 EP - 7 JF - Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale JO - Acta Otorhinolaryngol Ital VL - 23 IS - 1 N2 - Vocal fold paralysis is a pathological condition characterised by varying degrees of respiratory distress in relation to the degree of glottic stenosis. Dyspnoea may be present even when resting and may even require emergency tracheotomy. Frequently, the patient arrives for attention after the onset of exertional dyspnoea associated with a certain degree of dysphonia. The causes may be central or peripheral, more commonly iatrogenic following thyroid or tracheal surgery or secondary to injury. The aim of all surgical techniques used in the treatment of vocal fold paralysis is to restore a lumen sufficient to guarantee adequate breathing through the natural airway, without the patient having to permanently maintain the tracheotomy tube, while preserving acceptable phonatory quality. Between 1990 and 2001, at the Padua Hospital Unit of Endoscopic Airway Surgery, 48 patients (27 female, 21 male) were treated for respiratory distress secondary to vocal fold paralysis. At the beginning of this experience, 7 patients underwent arytenoidectomy with the Ossoff technique. In 34 cases, a modified Dennis-Kashima posterior cordectomy was performed. In 7 patients, since widening of the airway was necessary, cordectomy was extended to the false homolateral chord in 5 cases and to the arytenoid vocal process in another 2. In 9 patients, the operation was carried out with a Nd Yag (1064 nm) contact laser; the remaining 39 were treated with a GaArAl (810 nm) diode laser in use since 1995. Satisfactory results were obtained in all patients first treated by us and not already tracheotomised (35). In 23 cases (66%), results were considered "good" since no exertional dyspnoea occurred. In 12 patients (34%), the result was considered "sufficient" since there was no resting dyspnoea and normal everyday activity could be undertaken. Of the 13 patients already tracheotomised on arrival, 11 (85%) were decanulated on average 2 months after surgery. In conclusion, the present results show that endoscopic posterior cordectomy, performed by contact diode laser, gives reliable results, is rapid and simpler to perform than arytenoidectomy and guarantees a sufficient airway without impairing swallowing, while maintaining entirely acceptable voice quality. SN - 0392-100X UR - https://www.unboundmedicine.com/medline/citation/12812133/Contact_laser_surgery_in_treatment_of_vocal_fold_paralysis_ L2 - http://www.diseaseinfosearch.org/result/5584 DB - PRIME DP - Unbound Medicine ER -