CAC (Coblation Assisted Cordectomy) in Bilateral Vocal Cord Palsy- Tips & Tricks

CSurgeries ◽  
2021 ◽  
Author(s):  
Deepa Shivnani
Keyword(s):  
2021 ◽  
pp. 1-9
Author(s):  
Aditi Sinha ◽  
Alexander Geragotellis ◽  
Guntaj Kaur Singh ◽  
Devika Verma ◽  
Daniyal Matin Ansari ◽  
...  

Abstract Background: Vocal cord palsy is one of the recognised complications of complex cardiac surgery in the paediatric population. While there is an abundance of literature highlighting the presence of this complication, there is a scarcity of research focusing on the pathophysiology, presentation, diagnosis, and treatment options available for children affected by vocal cord palsy. Materials and methods: Electronic searches were conducted using the search terms: “Vocal Cord Palsy,” “VCP,” “Vocal Cord Injury,” “Paediatric Heart Surgery,” “Congenital Heart Surgery,” “Pediatric Heart Surgery,” “Vocal Fold Movement Impairment,” “VFMI,” “Vocal Fold Palsy,” “PDA Ligation.” The inclusion criteria were any articles discussing the outcomes of vocal cord palsy following paediatric cardiac surgery. Results: The two main populations affected by vocal cord palsy are children undergoing aortic arch surgery or those undergoing PDA ligation. There is paucity of prospective follow-up studies; it is therefore difficult to reliably assess the current approaches and the long-term implications of management options. Conclusion: Vocal cord palsy can be a devastating complication following cardiac surgery, which if left untreated, could potentially result in debilitation of quality of life and in severe circumstances could even lead to death. Currently, there is not enough high-quality evidence in the literature to aid recognition, diagnosis, and management leaving clinicians to extrapolate evidence from adult studies to make clinical judgements. Future research with a focus on the paediatric perspective is necessary in providing evidence for good standards of care.


PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 793-796 ◽  
Author(s):  
Robert E. Schumacher ◽  
Irvin J. Weinfeld ◽  
Robert H. Bartlett

Five cases of unilateral vocal cord paralysis/ paresis were diagnosed following extracorporeal membrane oxygenation for newborn respiratory failure. All were right sided and transient in nature. None of the five patients had other findings commonly associated with vocal cord palsy. The extracorporeal membrane oxygenation procedure requires surgical dissection in the carotid sheath on the right side of the neck, an area immediately adjacent to both the vagus and recurrent laryngeal nerve. It is speculated that vocal cord paralysis in these infants was acquired as a result of the extracorporeal membrane oxygenation cannulation. Although the vocal cord paralysis resolved in all cases, two patients had difficult courses after extracorporeal membrane oxygenation. Therefore, laryngoscopic examination should be considered for patients after extracorporeal membrane oxygenation.


1990 ◽  
Vol 104 (3) ◽  
pp. 267-269 ◽  
Author(s):  
A. E. Camilleri

AbstractThe management of acquired tracheo-oesophageal fistula due to tracheal intubation is reviewed and a case complicated by left vocal cord palsy and subglottic stenosis is presented. Permanent cricothyroidostomy was used in the management of this original triad of complications.


2003 ◽  
Vol 113 (3) ◽  
pp. 537-540 ◽  
Author(s):  
Tiemo Wessels ◽  
R. Sparing ◽  
C. Neuschaefer-Rube ◽  
C. Kl??tzsch

Author(s):  
Sanjeev Mohanty ◽  
Sreenivas . ◽  
Vinay Raj T. ◽  
Devipriya . ◽  
Vinoth M.

<p class="abstract"><strong>Background:</strong> Vocal cord paralysis is a clinical sign caused by paralysis of intrinsic muscles of larynx due to dysfunction of recurrent laryngeal nerve. There are several methods available surgically for the medialisation of the abducted vocal cord. One of the common effective modality is the Gore-Tex medialisation thyroplasty. The results depend on a number of factors including the surgical expertise and extrusion of the Gore –Tex implant. This study is aimed at analysis of all Gore-Tex medialisation thyroplasty done at our centre. Prospectively asses and analyze the vocal outcomes and quality of life of patients in type 1 medialisation thyroplasty using Gore-Tex implant.</p><p class="abstract"><strong>Methods:</strong> Prospective study of 48 months on 30 patients with unilateral vocal cord paralysis.  Surgical procedure for the patients was standardized by using Gore-Tex implant to medialize the cord. Video-Laryngoscopy at end of 1<sup>st</sup> month and stroboscopy &amp; voice analysis at end of 3<sup>rd</sup> month post treatment, the parameters used for the pre and post treatment objective analysis are a) stroboscopic analysis, b) psychoacoustic evaluation, c) maximum phonation time, d) patient’s self-assessment.  </p><p class="abstract"><strong>Results:</strong> In our study of 30 patients with a follow up period of 48 months, we can conclude as follows – a)unilateral vocal cord paralysis does not have age or gender specificity, b)statistically significant vocal cord palsy affects the left side more by 70%, c)post op Gore-tex medialisation thyroplasty showed a statistically highly significant improvement in psychoacoustic, mean phonation time, d)post op Gore-Tex medialisation thyroplasty showed a statistically significant improvement in videostroboscopic analysis.</p><p><strong>Conclusions:</strong> Psycho acoustic, mean phonation time analysis would complement each other in the assessment of the medialisation thyroplasty thus obviating videostroboscopy.</p>


Author(s):  
Irfan Mohamad ◽  
Nithya Kanesan ◽  
Norsyamira Aida Mohamad Umbaik ◽  
Norzaliana Zawawi

2011 ◽  
Vol 1 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Jayanthy Pavithran

ABSTRACT Objective The incidence of various causes of unilateral vocal cord palsy (UVCP) has been found to change over time and place. To arrive at the correct diagnosis is important in determining the prognosis as well as the time and mode of intervention. This study intends to evaluate the current etiological profile of unilateral vocal cord palsy in our center and compare it with the previous studies. Methods A retrospective study of case records of all consecutive patients with a diagnosis of UVCP presented to Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, South India in the period between September 2002 and May 2009 was conducted. The exclusion criteria were all laryngeal and hypopharyngeal malignancies, intubation injuries and cricoarytenoid joint ankylosis. Factors taken for analysis were age, gender, side of palsy and etiology. Results A total of 121 cases including 88 males and 33 females in the age range of 2 to 86 years were studied. 61.1% patients had left-sided palsy and 38.8% had right-sided palsy. The incidence of various etiologies were idiopathic (42.1%), surgical trauma (22.3%), nonsurgical trauma (6.61%), nonlaryngeal malignancy (6.61%), central (12.4%) and other benign lesions (9.09%). The incidence of all nonthyroidectomy surgeries together (59.3%) was more than that of thyroidectomy (40.7%). The most common individual surgical procedure was still thyroidectomy (11 cases, 40.7%) followed by coronary artery bypass grafting (CABG) (7 cases, 25.9%). Conclusion Idiopathic vocal cord palsy constituted the major subgroup. Thyroidectomy continues to be the single most common surgical procedure responsible for vocal cord palsy. Cardiac surgeries, trauma and cerebrovascular accidents are also increasingly causing vocal cord palsy, which is suggestive of the changing trend in life style and life expectancy. The right recurrent laryngeal nerve is not at higher risk than the left in thyroid surgery. Benign thyroid swellings also contribute significantly to UVCP.


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