[CO2 laser endoscopic subtotal arytenoidectomy for bilateral median vocal cord paralysis].
OBJECTIVE
To delineate the surgical procedures and correlated techniques for endoscopic subtotal arytenoidectomy, as well as to discuss their applications and clinical outcomes.


METHODS
CO2 Laser endoscopic unilateral arytenoidectomy was performed in eight cases of bilateral median vocal cord paralysis combined with one stage of mucosal micro-anastomosis. All patients suffered from dyspnea in some extent, of which 5 had the history of thyroidectomy and 2 had traumatic causes following esophagectomy and tracheal surgery respectively. One of patient had unknown cause. Six patients had undergone tracheotomy prior to operation or before their referral to our hospital. The airway was evaluated via fibro-optic laryngoscopy, and the voice quality was assessed subjectively by the patients and the surgeon before and after surgery.


RESULTS
Following 5-43 months after the surgery, in all cases the function of airway as well as the acceptable voice quality was successfully restored. The tracheotomy done before operation in six patients was decannulated within the mean time of 44.2 days post-operation.


CONCLUSIONS
The endoscopic approach for CO2 laser unilateral arytenoidectomy may lead to better restoration of an adequate airway and satisfying phonation without postoperative aspiration. Mucosal micro-anastomosis can prevent the formation of granulation or scar tissue thus promotes the healing processes. This procedure is simpler than other ordinary surgical methods, and could be a satisfactory alternation of treatment for bilateral median vocal cord paralysis.
Qin
Yong
Y
Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China. qinyong@public.bta.net.cn
Xiao
Shui-fang
SF
Wang
Quan-gui
QG
Li
Zhi-guang
ZG
Guo
Min
M
D000368:Aged; D001193:Arytenoid Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality