[Management of bilateral vocal cord paralysis with laser cordectomy].
BACKGROUND
Bilateral vocal fold paralysis (BVFP) is characterized by fold immobility in complete adduction or abduction, secondary to a vagus nerve lesion, through the recurrent laryngeal nerve. The manifestation is variable dyspnea and stridor, fatal if the airway is not secured. There are endolaryngeal and extralaryngeal techniques to increase the glottic opening, improving ventilation and deglutition, and the possibility of decannulation and phonation.


METHODS
Case series consisting of BVFP patients, treated with posterior cordectomy, from January 2004 to January 2010. Clinical charts were reviewed to obtain data and registries of presurgical and postsurgical control endolaryngoscopies.


RESULTS
Nineteen patients were identified. Twelve (63.2 %) had a tracheotomy cannula in place, and seven (36.8 %) didn't. Total thyroidectomy was the principal cause of the BVFP in 17 patients (89.5 %). A right cordectomy was performed on 10 patients (52.6 %). At 12 months, endolaryngoscopy detected a 40.26 % average increase in the glottic opening (p < 0.05), allowing for decannulation in 10 (83.3 %) of the tracheotomy patients.


CONCLUSIONS
Laser cordectomy is a simple procedure for the treatment of BVFP, with few complications, permitting oronasal ventilation, decannulation and phonation.
Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello. Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. clotildefuen@hotmail.com.
Luz del Carmen
Ldel C
Martínez-Oropeza
Alejandro
A
González-Ojeda
Luis Humberto
LH
Góvea-Camacho
Michel Dassaejv
MD
Macías-Amezcua
Clotilde
C
Fuentes-Orozco
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D014826:Vocal Cord Paralysis / Q000473:pathology / Q000601:surgery*
Laser therapy; Tracheotomy; Vocal cord paralysis