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Beeinträchtigung der Lebensqualität bei Patienten mit einseitiger Rekurrensparese nach thoraxchirurgischen Eingriffen

Reduced quality of life after thoracic surgery for unilateral vocal cord paralysis

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Zusammenfassung

Hintergrund

Postoperative einseitige Rekurrensparesen („unilateral recurrent laryngeal nerve paralysis“, URLNP) mit insuffizientem Glottisschluss können durch Dysphonie, Dysphagie und Störung der Atemstromkontrolle das Allgemeinbefinden beeinträchtigen. Ziel der interdisziplinären prospektiven Studie war es, die Lebensqualität von thoraxchirurgischen Patienten mit URLNP im Vergleich zu Patienten ohne Rekurrensschädigung zu beurteilen.

Patienten und Methoden

Es wurden 379 Patienten vor und nach einem thoraxchirurgischen Eingriff laryngoskopisch untersucht. Aus der Patientengruppe mit URLNP (n=14) konnten 9 Patienten im Vergleich zu einer entsprechend gematchten Patientengruppe ohne URLNP (n=10) hinsichtlich Stimm- und Lebensqualität mit standardisierten Fragebögen EORTC QLQ-C30, -H&N35, -OES18, -LC13 bzw. des Stimmstörungsindex (SSI nach Nawka) beurteilt werden.

Ergebnisse

Patienten mit URLNP hatten häufiger Probleme beim Sprechen und Abhusten sowie häufiger Stimmprobleme und gaben zudem eine Verschlechterung der Lebensqualität an.

Schlussfolgerung

Eine frühzeitige Diagnostik und Therapieeinleitung durch routinemäßige laryngoskopische Untersuchungen ist zu empfehlen.

Abstract

Background

Postoperative unilateral vocal cord paralysis (URLNP) may lead to a lower quality of life due to dysphonia, dysphagia, and reduced breathing control. The aim of this study was to evaluate quality of life in a group of patients with URLNP compared to a group without URLNP.

Patients and methods

Laryngoscopically, 379 patients were examined before and after thoracic surgery. Of the group with permanent URLNP (n=14), nine patients were compared to ten without URLNP regarding voice function and quality of life using selected European Organization for Research and Treatment of Cancer questionnaires (QLQ-C30, H&N35, OES18, and LC13) and the voice dysfunction index by Nawka.

Results

Patients with URLNP reported more voice problems and less effective coughing. Further, they had a reduced of quality of life.

Conclusion

We recommend early diagnosis of URLNP and therapy management by routine laryngoscopic examinations following thoracic surgery.

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Danksagung

Die Autoren danken Herrn Univ.-Prof. Dr. M. Kundi für die konstruktive Unterstützung bei der Durchführung der statistischen Datenanalysen.

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Keine Angaben

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Authors and Affiliations

  1. Klinische Abteilung für Phoniatrie – Logopädie, Universitätsklinik für Hals-Nasen-Ohren-Krankheiten Wien

    M. Zumtobel, W. Bigenzahn & B. Schneider

  2. Klinische Abteilung für Herz-Thorax-Chirurgie, Universitätsklinik für Chirurgie Wien

    A. End & W. Klepetko

  3. Allgemeines Krankenhaus der Stadt Wien, Universitätsklinik für Hals-Nasen-Ohren-Krankheiten, Währinger Gürtel 18–20, 1090, Wien, Österreich

    M. Zumtobel

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  1. M. Zumtobel
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  2. A. End
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  3. W. Bigenzahn
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  4. W. Klepetko
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  5. B. Schneider
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Corresponding author

Correspondence to M. Zumtobel.

Additional information

Die Ergebnisse der Studie wurden auf der 22. Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie in Berlin/BRD im September 2005 vorgetragen.

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Zumtobel, M., End, A., Bigenzahn, W. et al. Beeinträchtigung der Lebensqualität bei Patienten mit einseitiger Rekurrensparese nach thoraxchirurgischen Eingriffen. Chirurg 77, 518–522 (2006). https://doi.org/10.1007/s00104-006-1156-9

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  • DOI: https://doi.org/10.1007/s00104-006-1156-9

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