[Management of bilateral vocal cord paralysis with laser cordectomy].

Abstract

BACKGROUND:

Bilateral vocal fold paralysis (BVFP) is characterized by fold immobility in complete adduction or abduction, secondary to a vagus nerve lesion, through the recurrent laryngeal nerve. The manifestation is variable dyspnea and stridor, fatal if the airway is not secured. There are endolaryngeal and extralaryngeal techniques to increase the glottic opening, improving ventilation and deglutition, and the possibility of decannulation and phonation.

METHODS:

Case series consisting of BVFP patients, treated with posterior cordectomy, from January 2004 to January 2010. Clinical charts were reviewed to obtain data and registries of presurgical and postsurgical control endolaryngoscopies.

RESULTS:

Nineteen patients were identified. Twelve (63.2 %) had a tracheotomy cannula in place, and seven (36.8 %) didn't. Total thyroidectomy was the principal cause of the BVFP in 17 patients (89.5 %). A right cordectomy was performed on 10 patients (52.6 %). At 12 months, endolaryngoscopy detected a 40.26 % average increase in the glottic opening (p < 0.05), allowing for decannulation in 10 (83.3 %) of the tracheotomy patients.

CONCLUSIONS:

Laser cordectomy is a simple procedure for the treatment of BVFP, with few complications, permitting oronasal ventilation, decannulation and phonation.

• Authors: Luz del Carmen Martínez-Oropeza, Alejandro González-Ojeda, Luis Humberto Góvea-Camacho, Michel Dassaejv Macías-Amezcua, Clotilde Fuentes-Orozco
• Journal: Revista medica del Instituto Mexicano del Seguro Social (Rev Med Inst Mex Seguro Soc) 2014 Mar-Apr Vol. 52 Issue 2 Pg. 162-7 ISSN: 2448-5667 [Electronic] Mexico
• Vernacular Title: Manejo de la parálisis bilateral de cuerdas vocales mediante cordectomía con láser.
• PMID: 24758854 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Aged
• Female
• Humans
• Laser Therapy
• Male
• Middle Aged
• Vocal Cord Paralysis (pathology, surgery)