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Anales de Otorrinolaringología Mexicana

2013, Number 1

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Otorrinolaringología 2013; 58 (1)

Treatment of bilateral paralysis of vocal cords by laser cordectomy: experience at Centro Médico Nacional de Occidente

Venegas LP, Martínez OLC, Govea CLH, González OA, Fuentes OC

Language: Spanish
References: 26
Page: 12-20
PDF size: 355.05 Kb.


ABSTRACT

Background Bilateral vocal fold paralysis in adduction is due to lesion on both recurrent laryngeal nerves, caused principally by thyroid surgery. The main symptom is dyspnea with variable stridor. Even thought tracheotomy is still considered gold standard in emergency cases, it is not well accepted as definitive treatment. Laser cordectomy is a good technique for widening the glottic area, improving ventilation and allowing the possibility to decannulate patients with tracheotomy.
Objective To communicate the results of the management of bilateral vocal fold paralysis with laser cordectomy performed at Centro Medico Nacional de Occidente, in Mexico.
Material and methods A restrospective study of patients with diagnosis of bilateral vocal fold paralysis treated with cordectomy was done from January 2004 to January 2010. We searched clinical files to obtain data and registries of pre and postoperative videolaryngoscopies. Statistical analysis: descriptive, through frequencies and proportions, means and standard deviations.
Results We identified 19 patients, 12 patients (63.2%) had tracheotomy and 7 (36.8%) did not have. We had a mean of glottic area gain of 40.2%. We were able to decannulate 83.3% of the patients with tracheotomy. Comparing the mean of the initial glottic area with the final glottic area we could see that there was statistical significative difference (p ‹ 0.05).
Conclusions Laser cordectomy is a simple procedure, with low complication incidence and a good choice for treatment of bilateral vocal fold paralysis, since it allows decannulation of those patients who needed tracheotomy.


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