New technique for the treatment of bilateral vocal cord paralysis: Vocal and ventricular fold lateralization using crossing sutures with thyroplasty technique

Abstract Conclusion: All patients treated with this new lateralization technique had a good quality of life and no dyspnea at rest or upon exertion. We believe that this technique is an important addition to the many surgical techniques for the treatment of bilateral vocal cord paralysis (BVCP). Obj...

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Published in:	Acta oto-laryngologica Vol. 131; no. 3; pp. 303 - 309
Main Authors:	Katilmi, Hüseyin, Öztürkcan, Sedat, Ba o lu, Sinan, Aslan, Hale, lknur, Ali Ekber, Erdo an, Nezahat Karaca, Uluç, Muhsin Engin, Tayfun, Mehmet Ali, Dündar, R za, Güvenç, I l Adadan
Format:	Journal Article
Language:	English
Published:	Stockholm Informa Healthcare 01-03-2011 Taylor & Francis Informa
Subjects:	Adult airway obstruction Biological and medical sciences Chronic obstructive pulmonary disease, asthma Female Functional Laterality Humans Laryngoplasty - methods Laterofixation of vocal cord Male Medical sciences Middle Aged Otorhinolaryngology. Stomatology Pneumology Quality of Life Suture Techniques thyroid surgery complications Vocal Cord Paralysis - surgery Vocal Cords - surgery Implant Thyroplasty Respiratory disease Bilateral ENT Thyroid gland Vocal cord Laterofixation of vocal cord airway obstruction Vocal cord paralysis Treatment Surgery Complication Airways obstruction Larynx Technique Thyroid cartilage thyroid surgery complications Suture
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Summary:	Abstract Conclusion: All patients treated with this new lateralization technique had a good quality of life and no dyspnea at rest or upon exertion. We believe that this technique is an important addition to the many surgical techniques for the treatment of bilateral vocal cord paralysis (BVCP). Objectives: Most techniques used in the treatment of BVCP result in a prolapse of the laryngeal soft tissues into the endolarynx owing to Bernoulli's principle. We have developed a new lateralization technique to more effectively prevent this prolapse. Methods: The lateralization was initially tested on six cadaver larynges before being performed in five clinical cases with BVCP, who suffered from dyspnea at rest. Average follow-up was 17.6 months. As in type 1 thyroplasty, a rectangular piece of cartilage was excised horizontally from the thyroid lamina and placed on the defect in the vertical plane. Then, the vocal and ventricular folds were lateralized with crossing sutures, particularly in the posterior region. Results: Dyspnea was eliminated postoperatively. All patients were successfully decannulated. Postoperative voice quality was socially acceptable. Airways were improved postoperatively, as evaluated via fiberoptic laryngoscopy and CT. The mean preoperative and postoperative rima openings were 1.3 mm (range 0.5-2.6) and 6.4 mm (range 3.4-8.1), respectively.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0001-6489 1651-2251
DOI:	10.3109/00016489.2010.526143