gms | German Medical Science

83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2012, Mainz

Posterior cordomtomy for bilateral vocal cord paralysis: CO2 laser vs. microsurgery with cold instruments

Meeting Abstract

  • corresponding author Stelian Lupescu - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien
  • Alin H. Marin - Univ. Victor Babes, Dept. ENT, Timisoara, Rumanien
  • V. Draganescu - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien
  • Nicolae Balica - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien
  • Stan Cotulbea - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hnod023

doi: 10.3205/12hnod023, urn:nbn:de:0183-12hnod0230

Veröffentlicht: 4. April 2012

© 2012 Lupescu et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Idea: The restoration of the airways after bilateral vocal cord paralysis is still a challenge for the otolaryngologist. Techniques including endoscopic approaches (Kashima's technique) have been developed for management of adduction bilateral vocal cord paralysis.

Method: From 1998 to 2011, 20 patients were endoscopically treated by CO2 Laser (15 patients) and by cold microsurgical instruments (5 patients) in our ENT Department. A better and simpler procedure is cordotomy using the Kashima technique. This involves separating one vocal cord from the vocal process, creating a posterior gap for respiration and maintaining anterior vocal cord contact for phonation.

Results: The aetiology of vocal cord paralysis of our patients was the following: posttyroidectomy (8), central nervous system disease (7), idiopathic (5). All treatments were performed in one stage, except for one patient who underwent three month after operation a contralateral cordotomy. Post-operative assessment was performed and consisted of videolaryngoscopy with 70 degree rigid endoscope. The respiratory function and the phonation presented the similar results in both techniques. The healing process was delayed in cases of microsurgery with cold instruments. Speech therapy is used to supplement the operation.

Conclusion: Our experience suggests that bilateral vocal cord paralysis can be primarily treated by posterior cordotomy. Moreover, the different therapeutic choices should be adjusted by the surgeon for the patient's gender, age, general conditions, physical and professional activities.