Type I thyroplasty for acute unilateral vocal fold paralysis following intrathoracic surgery.
Patients who undergo intrathoracic operative procedures for malignancy may require sacrifice of a recurrent laryngeal nerve. Postoperative vocal fold paralysis may lead to diminished cough with secretion retention, aspiration, and life-endangering pneumonia. This study retrospectively reviews our institution's experience of 23 patients who underwent type I thyroplasty within the 2-week (acute) period after thoracic surgery. Primary lung cancer (n = 16) was the most common disease. Upper lobectomy (n = 9) and pneumonectomy (n = 7) were the most frequent surgical procedures. Silicone medialization alone (n = 11) or with arytenoid adduction (n = 12) was performed. There were no significant postoperative complications. Improvements in hoarseness (86%), dyspnea (72%), dysphagia (50%), and aspiration (79%) were noted. Pulmonary status improved after vocal fold medialization, as reflected by decreased need for therapeutic bronchoscopy in the majority of patients in the postoperative period. Type I thyroplasty for vocal fold paralysis in the acute phase following thoracic surgery is well tolerated and is associated with improved patient outcome with no postoperative deaths in this high-risk patient population.
Head and Neck Service and Speech, Hearing and Rehabilitation Center, New York, New York, USA.
Manoj T
MT
Abraham
Manjit S
MS
Bains
Robert J
RJ
Downey
Robert J
RJ
Korst
Dennis H
DH
Kraus
D001193:Arytenoid Cartilage / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012009:Recurrent Laryngeal Nerve / Q000601:surgery; D012189:Retrospective Studies; D013957:Thyroid Cartilage / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000601:surgery*