title: Microscopic bilateral posterior cordotomy in severe obstructive sleep apnea syndrome with bilateral vocal cord paralysis.
abstract: BACKGROUND
  Vocal cord paralysis is a rare cause of obstructive sleep apnea syndrome (OSAS). Recurrent laryngeal nerve injury after thyroid gland surgery is one of the leading causes of acquired vocal cord paralysis.
  
  
  METHODS
  A 46-year-old woman with OSAS due to bilateral abductor vocal cord paralysis was presented. She had thyroidectomy 30 years ago and had a weak, breathy voice. She had been referred with a history of high-pitched snoring, apnea witnessed by her spouse, and excessive daytime sleepiness for the last 5 years. Full-night polysomnography revealed that her apnea-hypopnea index was 72/h and minimal oxygen saturation level was 81%. There was no REM and deep sleep periods. Ear-nose-throat consultation offered an endoscopic bilateral posterior cordotomy operation via microscopic suspension laryngoscopy (MLS) as a treatment option.
  
  
  CONCLUSIONS
  Instead of using a nasal positive airway pressure (nCPAP) device, she was treated surgically. Her OSAS resolved completely within 5 months of the surgery. Her phonation was preserved, and symptoms such as snoring and hypersomnolance disappeared. In OSAS patients with bilateral vocal cord paralysis, MLS-associated bilateral posterior cordotomy can be a choice of treatment as an alternative to nCPAP application.
authors.affiliation: Faculty of Medicine, Department of Pulmonary Diseases, Maltepe University, Istanbul, Turkey. nessariman@yahoo.com
authors.forename: Nesrin
authors.initials: N
authors.lastname: Sarıman
authors.forename: Öncel
authors.initials: Ö
authors.lastname: Koca
authors.forename: Zerrin
authors.initials: Z
authors.lastname: Boyacı
authors.forename: Ender
authors.initials: E
authors.lastname: Levent
authors.forename: Akın Cem
authors.initials: AC
authors.lastname: Soylu
authors.forename: Sümeyye
authors.initials: S
authors.lastname: Alparslan
authors.forename: Attila
authors.initials: A
authors.lastname: Saygı
mesh_terms: D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D010699:Phonation; D017286:Polysomnography; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D061226:Recurrent Laryngeal Nerve Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014827:Vocal Cords / Q000601:surgery*