[Early indications for surgical vocal cord medial relocation in unilateral recurrent nerve paralysis in advanced age].
BACKGROUND
Unilateral vocal cord paralysis is usually treated conservatively. Phonosurgery is not indicated before 1 year after the onset of the palsy as during this period spontaneous recovery can be expected. In the elderly patient conservative voice rehabilitation is often limited by a restricted general condition. In these cases a severe communication disorder may result unless vocal cord function recovers spontaneously.


METHODS
In 4 patients aged 68 to 79 years who had suffered from latrogenic unilateral vocal cord paralysis for 6 to 9 months, surgical medialisation of the paralysed vocal cord was carried out in local anaesthesia as an Isshiki-Type-I-operation after unsuccessful conservative treatment prior to surgery.


RESULTS
In all cases a definite amelioration of voice function could be reached. There were no local or general complications. No spontaneous recovery of nerve function could be detected by electromyography between 6 to 9 months after the operation. Voice function remained stable during this period.


CONCLUSIONS
We conclude that in elderly patients with unilateral vocal cord paralysis with no signs of spontaneous recovery and unsuccessful conservative treatment, surgical voice rehabilitation may be indicated before 1 year after the onset of the palsy.
Rosanowski
F
F
Abteilung für Phoniatrie und Pädaudiologie, Friedrich-Alexander-Universität Erlangen-Nümberg.
Tigges
M
M
Pröschel
U
U
Eysholdt
U
U
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D061226:Recurrent Laryngeal Nerve Injuries; D012086:Reoperation; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000601:surgery*; D014833:Voice Quality / Q000502:physiology
Frühzeitige Indikation zur operativen Stimmlippenmedianverlagerung bei einseitigen Recurrensparesen im fortgeschrittenen Lebensalter.