Document Detail

"Early" vocal cord laterofixation for the treatment of bilateral vocal cord immobility.
MedLine Citation:
PMID:  11829186     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Vocal cord immobility (VCI) is commonly caused by a nonlaryngeal malignancy, thyroid surgery, or a presumed viral insult etc. The paralysis is often transient or temporary, thus the care of the patient should be optimized to avoid unnecessary diagnostic and therapeutic endeavours. This article reports on the result of the concept of early vocal cord laterofixation, which provides a minimally invasive solution to dyspnea in the critical early, potentially reversible, period of bilateral VCI. STUDY DESIGN: A prospective study of 25 consecutive patients (ages 33 to 81 years) who were diagnosed with a bilateral VCI. This condition had developed after thyroid surgery in 22 of the patients and after a blunt trauma of the neck in one case. In another case, a cricoarytenoid joint fixation was revealed, and aetiology remained unknown in one further patient. METHODS: The surgical procedure was performed endoscopically with a modification of Lichtenberger's endo-extralaryngeal suture lateralization technique. The abducted vocal cord position was achieved by inserting a non-resorbable thread around the vocal process and tying on to the prelaryngeal muscles. Regular spirometric measurements and radiological aspiration tests were conducted on the patients. RESULTS: Adequate postoperative airway was achieved in all patients except one. Significant spontaneous vocal cord medialization was observed in two cases within a year and in three patients in the second and the third year. Partial or complete vocal cord recovery was observed in 17 cases. Further voice improvement followed in 9 patients when the threads were removed, due to vocal cord medialization or recovery. The mild postoperative aspirations ceased in the first postoperative days in all cases except one. CONCLUSIONS: The concept of "early" laterofixation satisfies the important criteria: it can provide an immediate and long-lasting adequate airway, and it can be considered potentially reversible from the point of view of laryngeal functions. Thus the procedure is a reliable primary treatment for bilateral VCI.
L Rovó; J Jóri; L Iván; M Brzózka; J Czigner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery     Volume:  258     ISSN:  0937-4477     ISO Abbreviation:  Eur Arch Otorhinolaryngol     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-02-06     Completed Date:  2002-07-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9002937     Medline TA:  Eur Arch Otorhinolaryngol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  509-13     Citation Subset:  IM    
Department of Otorhinolaryngology, Medical Faculty of University of Sciences, Szeged, Hungary.
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MeSH Terms
Aged, 80 and over
Follow-Up Studies
Laryngoscopy / methods*
Middle Aged
Sensitivity and Specificity
Surgical Procedures, Minimally Invasive / methods
Suture Techniques
Treatment Outcome
Vocal Cord Paralysis / diagnosis,  surgery*

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