title: Long-term results in patients after combined laser total arytenoidectomy with posterior cordectomy for bilateral vocal cord paralysis.
abstract: The problem of ventilation efficiency after total laser arytenoidectomy with posterior cordectomy due to bilateral vocal cord paralysis is discussed. There are a number of views on the usefulness and efficacy of different surgical procedures aimed at widening the glottis, but the studies concerning the long-term functional results are still lacking. The objective of the study is to evaluate the durability of ventilation results in patients after laser arytenoidectomy with posterior cordectomy based on the comparison between the early postoperative results and those assessed after a period of 5 years. Thirty patients (24 females, 6 males) aged between 30 and 80 (mean 58.5) with bilateral vocal cord paralysis after thyroid surgery, who underwent laser arytenoidectomy with posterior cordectomy, were analyzed. Ventilation tests were performed immediately after the operation and 5 years later with Body-Master Laab (Jaeger). The actual and predicted values of FVC, FEF(25), FEF(50), FEF(75), PEF, MMEF(75/25), AREA(Ex), sR(T0T), R(T0T) were compared and analyzed. Also, the values of the inspiratory parameters FIV(1), FIF(50), PIF and the coefficients FEF(50)/FIF(50) and FIV(1)/FEV(1) were assessed. Moreover, subjective evaluation was performed based on a questionnaire. The statistical analysis reveals a significant decrease in FIV(1), FIF(50), PIF and FIV(1)/FEV(1). FEF(50)/FIF(50) and sR(T0T) (actual and predicted values) increased significantly after 5 years from the operation. However, the patients did not complain nor was this tendency reflected in their answers to the questionnaire. The probable reasons for such ventilation results are discussed. The role of phoniatric rehabilitation and the time elapsed is emphasized. In general, it can be concluded that laser arytenoidectomy with posterior cordectomy is a durable and effective procedure, although the objective assessment does not fully match the patient's subjective impression.
authors.affiliation: ENT Department, Silesian Medical University, Sklodowskiej-Curie 10, 41-800, Zabrze, Poland. misiol@mp.pl
authors.forename: Maciej
authors.initials: M
authors.lastname: Misiolek
authors.forename: Dariusz
authors.initials: D
authors.lastname: Ziora
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Namyslowski
authors.forename: Hanna
authors.initials: H
authors.lastname: Misiolek
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Kucia
authors.forename: Wojciech
authors.initials: W
authors.lastname: Scierski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Kozielski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Warmuzinski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001193:Arytenoid Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010991:Plethysmography; D012129:Respiratory Function Tests; D013965:Thyroidectomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*