title: Current therapeutic prospectives in the functional rehabilitation of vocal fold paralysis after thyroidectomy: CO2 laser aritenoidectomy.
abstract: A frequent complication of thyroid surgery is laryngeal nerve palsy with transitory or permanent deficiency of cordal motility. Peripheral mono-or bilateral palsy in these cases may either occur, in adduction or abduction, and be complete or not complete. Bilateral vocal cords paralysis cause a persistent dyspnoic symptomatology with worsening during physical exercise or flogistic episodes of the upper airway: true vocal cords adduction, in median or paramedian position reduce the glottic space and increases respiratory resistances. Several surgical procedures have been proposed for the treatment of respiratory distress secondary to bilateral cord palsy. The aim of this study is to value the role of CO2 laser aritenoidectomy in 93 patients affected by bilateral paralysis in adduction of true vocal cords. Pre and postoperative evaluations included clinical results, spirometry, aerodynamics studies and evaluation of foniatric performance (MPT, H/N Ratio, Jitter and Shimmer) with a mean follow-up of 12 years. CO2 laser aritenoidectomy induces a complete resolution of respiratory failure, maintaining a good vocal quality, minimum surgical stress with low percentage of complications and a short hospitalization.
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Italy. Electronic address: domenico.testa@unina2.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Testa
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Germano
authors.initials: G
authors.lastname: Guerra
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Italy.
authors.forename: Pasquale Gianluca
authors.initials: PG
authors.lastname: Landolfo
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Nunziata
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Department of Neuroscience Reproductive and Dentistry Sciences, Otolaryngology Unit, University of Naples "Federico II", Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mesolella
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Motta
mesh_terms: D000328:Adult; D000368:Aged; D001193:Arytenoid Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010699:Phonation / Q000502:physiology; D011446:Prospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*
keywords: Acoustic and spirometric parameters; CO(2) laser aritenoidectomy; Thyroidectomy; Vocal fold paralysis; Voice quality