Abstract
Objective
To assess the results of endoscopic laser surgery in cases of bilateral abductor palsy on basis of respiration, preservation of voice (phonation) and swallowing.
Methods
This retrospective study includes 48 patients (34 males and 14 females) from 5 years to 68 years of age at the time of intervention. 41 cases were operated with subtotal arytenoidectomy and 7 with unilateral posterior cordectomy. 32 patients were operated with tracheostomy and 16 with combination of intuabtion and jet ventilation.
Results
29 out of 32 tracheostomised patients were decannulated (91%). Respiration was adequate for daily routine activities in most of the operated patients. Phonation was normal to near normal in 32 cases out of the operated 34 adult patients (95%). Most of the patients had normal swallowing following surgery.
Conclusion
Subtotal arytenoidectomy with endoscopic laser surgery in cases of bilateral abductor paralysis has established its place as a preferred surgical method to obtain good respiration, phonation and swallowing. It minimizes the surgical time, hospital stay and morbidity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Jackson C (1922) Ventriculocordectomy. A new operation for the cure of goitrous glottic stenosis. Arch Surg 4:257–274
King BT (1939) A new and function restoring operation for bilateral abductor cord paralysis. JAMA 112:814–823
Kelly JD (1941) Surgical treatment of bilateral paralysis of the abductor muscles. Arch Otolaryngol 33:293–304
Thornell WC (1948) Intralaryngeal approach for arytenoidectomy in bilateral abductor vocal cord paralysis. Arch Otolaryngol 47:505–508
Downey WC, Keenan WG (1968) Laryngofissure approach for bilateral abductor paralysis. Arch Otolaryngol 88:513–517
Zealer DL, Dedo HH (1977) Control of paralysed axial muscles by electrical stimulation. Acta Otolaryngol (Stockh) 83:514–527
Kirchner FR (1979) Endoscopic lateralization of the vocal cords in abductor paralysis of the larynx. Laryngoscope 89:1779–1783
Dennis DP, Kashima H (1989) Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 98:930–934
Marc Remacle, Georges Lawson, Alain Mayne, Jacques Jamart (1996) Subtotal carbon dioxide laser arytenoidectomy by endoscopic approach for treatment of bilateral cord immobility in adduction. Ann Otol Rhinol Laryngol 105:438–445
V. Oswal and M. Remacle (2002) Laser Surgery for benign laryngeal pathology In: V. Oswal, M. Remacle, eds. Principles and practice of lasers in otorhinolaryngology and head and neck surgery. The Hague, The Netherlands: Kugler Publications 91–117
Wani MK, Yarber R. Hengesteg A, Rosen C, Woodson GE (1996) Endoscopic laser medial arytenoidectomy versus total arytenoidectomy in the management of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 105:857–862
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Oswal, V.H., Gandhi, S.S. Endoscopic laser management of bilateral abductor palsy. Indian J Otolaryngol Head Neck Surg 61 (Suppl 1), 47–51 (2009). https://doi.org/10.1007/s12070-009-0017-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-009-0017-5