Bilateral Vocal Fold Immobility Treatment
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Abstract
Bilateral medial vocal fold immobility, can be caused by various etiologies and can lead to severe dyspnea that may risk patients life. There are several surgical techniques for increasing the glottic space, prevailing transoral surgeries that remove tissue. The objective of this study is to determine the rate of resolution of inspiratory dyspnea and decanulation in patients with bilateral vocal cord immobility in adduction. In this study 17 patients diagnosed with bilateral vocal fold immobility in adduction were treated with posterior cordotomy and partial medial arytenoidectomy with transoral approach, using CO2 laser, radiofrequency or electrocautery. Eight of our patients were tracheostomized. Six of the tracheostomized patients had their tracheostomies removed (6 out of 8, 75%). Nine without tracheostomy showed improvement of inspiratory dyspnea and had no limitation on their daily lives activities. (9 out of 9, 100%). As a conclussion, we can say that transoral cordotomy and partial arytenoidectomy were very effective in improving the caliber of the upper airway, with low morbidity and no complications
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Bigenzahn W, Hoefler H. Minimally invasive laser surgery for the treatment of bilateral vocal cord paralysis. Laryngoscope. 1996;106(6):791-3. DOI: https://doi.org/10.1097/00005537-199606000-00024
Dennis DP, Kashima H. Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol. 1989;98(12 Pt1):930-4. DOI: https://doi.org/10.1177/000348948909801203
Kim HM, Kwon SK, Hah JH, et al. Laser-assisted endoscopic submucosal medial arytenoidectomy (LESMA). Laryngoscope. 2007;117(9):1611-4. DOI: https://doi.org/10.1097/MLG.0b013e31806bf2e0
Laccourreye O, Paz Escovar MI, Gerhardt J, et al. CO2 laser endoscopic posterior partial transverse cordotomy for bilateral paralysis of the vocal fold. Laryngoscope. 1999;109(3):415-8. DOI: https://doi.org/10.1097/00005537-199903000-00014
Szakács L, Sztanó B, Matievics V, et al. A comparison between transoral glottis-widening techniques for bilateral vocal fold immobility. Laryngoscope. 2015;125(11):2522-9. DOI: https://doi.org/10.1002/lary.25401
Özdemir S, Tuncer Ü, Tarkan Ö, et al. Carbon dioxide laser endoscopic posterior cordotomy technique for bilateral abductor vocal cord paralysis: a 15-year experience. JAMA Otolaryngol Head Neck Surg. 2013;139(4):401-4. DOI: https://doi.org/10.1001/jamaoto.2013.41
Lichtenberger G, Toohill RJ. Technique of endo-extralaryngeal suture lateralization for bilateral abductor vocal cord paralysis. Laryngoscope. 1997;107(9):1281-3. DOI: https://doi.org/10.1097/00005537-199709000-00023
Lichtenberger G. Reversible lateralization of the paralyzed vocal cord without tracheostomy. Ann Otol Rhinol Laryngol. 2002;111(1):21-6. DOI: https://doi.org/10.1177/000348940211100104
Martínez-Oropeza Ldel C, González-Ojeda A, Góvea-Camacho LH, et al. [Management of bilateral vocal cord paralysis with laser cordectomy]. Rev Med Inst Mex Seguro Soc. 2014;52(2):162-7. Spanish.
Ossoff RH, Sisson GA, Duncavage JA, et al. Endoscopic laser arytenoidectomy for the treatment of bilateral vocal cord paralysis. Laryngoscope. 1984;94(10):1293-7. DOI: https://doi.org/10.1288/00005537-198410000-00006
Remacle M, Lawson G, Mayné A, et al. Subtotal carbon dioxide laser arytenoidectomy by endoscopic approachfor treatment of bilateral cord immobility in adduction. Ann Otol Rhinol Laryngol. 1996;105(6):438-45. DOI: https://doi.org/10.1177/000348949610500604
Rontal M, Rontal E. Use of laryngeal muscular tenotomy for bilateral midline vocal cord fixation. Ann Otol Rhinol Laryngol. 1994;103(8 Pt 1):583-9. DOI: https://doi.org/10.1177/000348949410300801
Rosenthal LH, Benninger MS, Deeb RH. Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope. 2007;117(10):1864-70. DOI: https://doi.org/10.1097/MLG.0b013e3180de4d49
Nawka T, Sittel C, Gugatschka M, et al. Permanent transoral surgery of bilateral vocal fold paralysis: a prospective multi-center trial. Laryngoscope. 2015;125(6):1401-8. DOI: https://doi.org/10.1002/lary.25137
Zealear DL, Billante CR, Courey MS, et al. Electrically stimulated glottal opening combined with adductor muscle botox blockade restores both ventilation and voice in a patient with bilateral laryngeal paralysis. Ann Otol Rhinol Laryngol. 2002;111(6):500-6. DOI: https://doi.org/10.1177/000348940211100605
Zealear DL, Billante CR, Courey MS, et al. Reanimation of the paralyzed human larynx with an implantable electrical stimulation device. Laryngoscope. 2003;113(7):1149-56 DOI: https://doi.org/10.1097/00005537-200307000-00010