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[Usefulness of laser arytenoidectomy and laterofixation in treatment of bilateral vocal cord paralysis].
Otolaryngol Pol. 2012 Mar-Apr; 66(2):109-16.OP

Abstract

INTRODUCTION

Bilateral vocal cord paralysis is caused by the damage of both recurrent laryngeal nerves. Such a pathology is not commonplace in the ordinary medical practice. It most often occurs as a complication after the thyroid gland surgery or thyroid re-surgery. In the case of bilateral vocal cord paralysis the treatment of the patient includes performing immediate tracheotomy or one of the surgeries aiming at widening the glottis because of dyspnea caused by the upper respiratory tract obstruction on the glottis level.

AIM

The comparison of efficacy and usefulness of two surgical techniques performed to widen the glottis – laser arytenoidectomy with posterior cordectomy and laterofixation.

MATERIAL AND METHODS

The research was carried out on the group of 57 patients suffering from bilateral vocal cord paralysis who, in the period of 1997–2009, underwent treatment in ENT Department in Zabrze Medical University of Silesia in Katowice. The first group included 36 patients who underwent laser arytenoidectomy with posterior chordectomy. The second group included 21 patients who underwent laterofixation. All of the patients treated with the laser arytenoidectomy with posterior cordectomy and laterofixation were subjected to respiratory system ventilation examinations before the procedure of widening the glottis and after the healing, at least 4 months after the surgery. Making self-evaluation, each of the patients answered a question concerning the improvement of their breathing comfort after the surgery. The patients from both groups underwent the vocal apparatus examination which included: subjective perceptive voice analysis according to GRBAS scale, videolaryngostroboscopy, evaluation of the maximum phonation time, self-evaluation survey of the post-surgical voice quality.

RESULTS

Among 57 patients suffering from bilateral vocal cord paralysis and operated by arytenoidectomy with posterior cordectomy (group I) and laterofixation (group II), a subjective improvement of the comfort of living was achieved which resulted in the possibility of making more physical activities. From the first group, 35 out of 36 patients were decannulated. In the second group, both patients who had previously undergone tracheotomy were successfully decannulated. There were no statistically significant differences in the increase of selected ventilation markers between the patients who underwent laser arytenoidectomy and those who underwent laterofixation. There were no substantial discrepancies in the perceptive voice analysis in GRBAS scale between the patients after laser arytenoidectomy and those treated with the technique of laterofixation. When asked about their post-surgical voice quality, the patients of the first and the second group rated their voice as worse than before the surgery.

CONCLUSION

Both surgical techniques, laser arytenoidectomy with posterior cordectomy and laterofixation, are efficient and useful in widening the glottis in the case of bilateral vocal cord paralysis. The improvement of the ventilation markers allows the growth in the comfort of living, restoration of the physiological respiratory tract and decannulation of the patients who had undergone tracheotomy. The deterioration of the voice quality is characteristic of both surgical techniques.

Authors+Show Affiliations

Katedra i Odział Kliniczny Laryngologii, w Zabrzu, Śląskiego Uniwersytetu Medycznego, w Katowicach.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

pol

PubMed ID

22500500

Citation

Misiołek, Maciej, et al. "[Usefulness of Laser Arytenoidectomy and Laterofixation in Treatment of Bilateral Vocal Cord Paralysis]." Otolaryngologia Polska = the Polish Otolaryngology, vol. 66, no. 2, 2012, pp. 109-16.
Misiołek M, Kłębukowski L, Lisowska G, et al. [Usefulness of laser arytenoidectomy and laterofixation in treatment of bilateral vocal cord paralysis]. Otolaryngol Pol. 2012;66(2):109-16.
Misiołek, M., Kłębukowski, L., Lisowska, G., Czecior, E., Ścierski, W., Orecka, B., & Namysłowski, G. (2012). [Usefulness of laser arytenoidectomy and laterofixation in treatment of bilateral vocal cord paralysis]. Otolaryngologia Polska = the Polish Otolaryngology, 66(2), 109-16. https://doi.org/10.1016/S0030-6657(12)70757-6
Misiołek M, et al. [Usefulness of Laser Arytenoidectomy and Laterofixation in Treatment of Bilateral Vocal Cord Paralysis]. Otolaryngol Pol. 2012 Mar-Apr;66(2):109-16. PubMed PMID: 22500500.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Usefulness of laser arytenoidectomy and laterofixation in treatment of bilateral vocal cord paralysis]. AU - Misiołek,Maciej, AU - Kłębukowski,Leszek, AU - Lisowska,Grażyna, AU - Czecior,Eugeniusz, AU - Ścierski,Wojciech, AU - Orecka,Bogusława, AU - Namysłowski,Grzegorz, PY - 2011/03/29/received PY - 2011/07/21/accepted PY - 2012/4/17/entrez PY - 2012/4/17/pubmed PY - 2012/7/4/medline SP - 109 EP - 16 JF - Otolaryngologia polska = The Polish otolaryngology JO - Otolaryngol Pol VL - 66 IS - 2 N2 - INTRODUCTION: Bilateral vocal cord paralysis is caused by the damage of both recurrent laryngeal nerves. Such a pathology is not commonplace in the ordinary medical practice. It most often occurs as a complication after the thyroid gland surgery or thyroid re-surgery. In the case of bilateral vocal cord paralysis the treatment of the patient includes performing immediate tracheotomy or one of the surgeries aiming at widening the glottis because of dyspnea caused by the upper respiratory tract obstruction on the glottis level. AIM: The comparison of efficacy and usefulness of two surgical techniques performed to widen the glottis – laser arytenoidectomy with posterior cordectomy and laterofixation. MATERIAL AND METHODS: The research was carried out on the group of 57 patients suffering from bilateral vocal cord paralysis who, in the period of 1997–2009, underwent treatment in ENT Department in Zabrze Medical University of Silesia in Katowice. The first group included 36 patients who underwent laser arytenoidectomy with posterior chordectomy. The second group included 21 patients who underwent laterofixation. All of the patients treated with the laser arytenoidectomy with posterior cordectomy and laterofixation were subjected to respiratory system ventilation examinations before the procedure of widening the glottis and after the healing, at least 4 months after the surgery. Making self-evaluation, each of the patients answered a question concerning the improvement of their breathing comfort after the surgery. The patients from both groups underwent the vocal apparatus examination which included: subjective perceptive voice analysis according to GRBAS scale, videolaryngostroboscopy, evaluation of the maximum phonation time, self-evaluation survey of the post-surgical voice quality. RESULTS: Among 57 patients suffering from bilateral vocal cord paralysis and operated by arytenoidectomy with posterior cordectomy (group I) and laterofixation (group II), a subjective improvement of the comfort of living was achieved which resulted in the possibility of making more physical activities. From the first group, 35 out of 36 patients were decannulated. In the second group, both patients who had previously undergone tracheotomy were successfully decannulated. There were no statistically significant differences in the increase of selected ventilation markers between the patients who underwent laser arytenoidectomy and those who underwent laterofixation. There were no substantial discrepancies in the perceptive voice analysis in GRBAS scale between the patients after laser arytenoidectomy and those treated with the technique of laterofixation. When asked about their post-surgical voice quality, the patients of the first and the second group rated their voice as worse than before the surgery. CONCLUSION: Both surgical techniques, laser arytenoidectomy with posterior cordectomy and laterofixation, are efficient and useful in widening the glottis in the case of bilateral vocal cord paralysis. The improvement of the ventilation markers allows the growth in the comfort of living, restoration of the physiological respiratory tract and decannulation of the patients who had undergone tracheotomy. The deterioration of the voice quality is characteristic of both surgical techniques. SN - 0030-6657 UR - https://www.unboundmedicine.com/medline/citation/22500500/[Usefulness_of_laser_arytenoidectomy_and_laterofixation_in_treatment_of_bilateral_vocal_cord_paralysis]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0030-6657(12)70757-6 DB - PRIME DP - Unbound Medicine ER -