open access

Vol 66, No 5 (2015)
Original papers
Published online: 2015-10-12
Submitted: 2015-04-07
Accepted: 2015-06-25
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Possibilities of surgical correction of vocal cord palsy after thyroid gland operations

Grazyna Lisowska, Pawel Sowa, Hanna Misiolek, Wojciech Scierski, Maciej Misiolek
DOI: 10.5603/EP.2015.0051
·
Endokrynologia Polska 2015;66(5):412-416.

open access

Vol 66, No 5 (2015)
Original papers
Published online: 2015-10-12
Submitted: 2015-04-07
Accepted: 2015-06-25

Abstract

Introduction: Surgery of the thyroid gland remains the main cause of bilateral vocal cord palsy (VCP). Ventilation problem is the main problem in such situations. There are a couple of corrective surgical procedures in the case of VCP. The aim of our study was to show the possibility of widening of the glottis, and to evaluate the techniques and effects of surgical treatments due to bilateral VCP resulting from thyroid gland surgery.

Material and methods: Five methods of surgical treatment were used: laser-assisted posterior cordectomy, according to Denis and Kashima; laser-assisted bilateral medial arytenoidectomy, as proposed by Crumley; laser-assisted posterior ventriculocordectomy, as described by Pia; laser-assisted total arytenoidectomy with posterior cordectomy, as presented by Ossoff; and laterofixation, according to Lichtenberger. The postoperative patient’s subjective improvement was assessed using visual analogue scale.

Results: Between 1998 and 2014 we operated on 270 patients with bilateral VCP. Paresis occurred as the result of the iatrogenic effect of thyroid gland surgery in 255 patients (94.4%) vs. 15 (7.6%) from other causes. The majority of our patients (77.6%) had undergone laser arytenoidectomy with posterior partial cordectomy, and in 13.7% of them Lichtenberger laterofixation had been performed. Ossoff ’s surgery gives good ventilation results: successful decannulation (62.9% after first surgery; 97.6% final rate) and significant subjective ventilation improvement in 96% of patients.

Conclusions: Ossoff ’s laser arytenoidectomy with posterior cordectomy is a safe procedure that gives acceptable ventilation improvement. Patients report satisfactory quality of life and the possibility of returning to active professional life. Laterofixation should be considered as an alternative for tracheotomy rather than permanent procedure. (Endokrynol Pol 2015; 66 (5): 412–416)

Abstract

Introduction: Surgery of the thyroid gland remains the main cause of bilateral vocal cord palsy (VCP). Ventilation problem is the main problem in such situations. There are a couple of corrective surgical procedures in the case of VCP. The aim of our study was to show the possibility of widening of the glottis, and to evaluate the techniques and effects of surgical treatments due to bilateral VCP resulting from thyroid gland surgery.

Material and methods: Five methods of surgical treatment were used: laser-assisted posterior cordectomy, according to Denis and Kashima; laser-assisted bilateral medial arytenoidectomy, as proposed by Crumley; laser-assisted posterior ventriculocordectomy, as described by Pia; laser-assisted total arytenoidectomy with posterior cordectomy, as presented by Ossoff; and laterofixation, according to Lichtenberger. The postoperative patient’s subjective improvement was assessed using visual analogue scale.

Results: Between 1998 and 2014 we operated on 270 patients with bilateral VCP. Paresis occurred as the result of the iatrogenic effect of thyroid gland surgery in 255 patients (94.4%) vs. 15 (7.6%) from other causes. The majority of our patients (77.6%) had undergone laser arytenoidectomy with posterior partial cordectomy, and in 13.7% of them Lichtenberger laterofixation had been performed. Ossoff ’s surgery gives good ventilation results: successful decannulation (62.9% after first surgery; 97.6% final rate) and significant subjective ventilation improvement in 96% of patients.

Conclusions: Ossoff ’s laser arytenoidectomy with posterior cordectomy is a safe procedure that gives acceptable ventilation improvement. Patients report satisfactory quality of life and the possibility of returning to active professional life. Laterofixation should be considered as an alternative for tracheotomy rather than permanent procedure. (Endokrynol Pol 2015; 66 (5): 412–416)

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Keywords

vocal cord palsy; vocal cord paralysis; arytenotidectomy; laterofixation; thyroid gland surgery complication; mytomicin-C

About this article
Title

Possibilities of surgical correction of vocal cord palsy after thyroid gland operations

Journal

Endokrynologia Polska

Issue

Vol 66, No 5 (2015)

Pages

412-416

Published online

2015-10-12

DOI

10.5603/EP.2015.0051

Bibliographic record

Endokrynologia Polska 2015;66(5):412-416.

Keywords

vocal cord palsy
vocal cord paralysis
arytenotidectomy
laterofixation
thyroid gland surgery complication
mytomicin-C

Authors

Grazyna Lisowska
Pawel Sowa
Hanna Misiolek
Wojciech Scierski
Maciej Misiolek

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