Efficacy of laser arytenoidectomy in bilateral vocal cord paralysis. The review of the contemporary surgical procedures

Abstract

Background: Bilateral vocal cord paralysis is a symptom which needs exact diagnosis. It causes serious ventilation disturbances, voice impairment and may lead to limitation of the protection of the lower airways. The treatment of bilateral vocal cord paralysis presents a challenge to head and neck surgeons because it is a compromise between phonation, restoration and laryngeal closure during swallowing and respiration. Many techniques have been developed in an attempt to improve the patient’s airway insufficiency. None of them was found to the best.
The aim of this study was to evaluate the efficacy of laser arytenoidectomy and to review contemporary surgical procedures.
Material and methods: The ventilation results of 36 patients (33 F/3 M, age range 24-76; mean 52.17) obtained pre- and post-operatively were analyzed. A special control group of 15 patients with unilateral vocal cord paralysis was introduced. A laser arytenoidectomy with posterior cordectomy was performed in all patients.
Results: Ventilation improvement was observed in all cases. 35 out of 36 were decannulated. Chosen spirometric parameters increased significantly.
Conclusions: According to the results gained, the laser arytenoidectomy with posterior cordectomy was found to be a useful procedure. Other authors’ opinions concerning different surgical procedures in bilateral vocal cord paralysis were analyzed and discussed.