title: Permanent transoral surgery of bilateral vocal fold paralysis: a prospective multi-center trial.
abstract: OBJECTIVE
  To describe postoperative adverse events (AEs) and outcomes after transoral surgery for bilateral vocal fold paralysis (BVFP).
  
  
  METHODS
  Prospective observational multicenter study.
  
  
  METHODS
  Thirty-six patients with BVFP underwent transoral surgery using standard surgical procedures to unilaterally widen the glottic area. Postoperative adverse events (AEs) including severe adverse events (SAEs) were registered continuously. Pre- and 6-month postoperative evaluations included the 6-Minute Walk Test, the 36-Item Short Form Health Survey (SF-36), the Glasgow Benefit Inventory, the 12-Item Voice Handicap Index (VHI-12), and a Fiberoptic Endoscopic Evaluation of Swallowing graded according to the Penetration-Aspiration-Scale.
  
  
  RESULTS
  The patients underwent posterior cordotomy, partial arytenoidectomy, or permanent laterofixation as single procedures or in combination. Forty-seven percent of the patients had postoperative AEs. Dyspnea was the most frequent AE (45%). In 40% of AEs, the events were severe (SAEs), and 72.5% were related to the study intervention. Revision surgery leading to prolonged hospitalization or rehospitalization was necessary in nine cases (25%). Laterofixation was correlated to a decreased risk of AEs (P = 0.042). Six months after surgery, a significant improvement was seen in the SF-domains: Physical component score (P = 0.008), physical functioning (P = 0.001), physical role (P = 0.031), and vitality (P = 0.032). Concerning the voice handicap, only the VHI-12 physical subscore showed a decrease (P = 0.005). The total score and other VHI-12 subscores did not change significantly (all P > 0.05).
  
  
  CONCLUSIONS
  BCVP patients profit from modern transoral surgery for unilateral glottic widening; quality of life is improved; and the voice is preserved. Nevertheless, postoperative complications are frequent.
  
  
  METHODS
  2b.
authors: Department of Audiology and Phoniatrics, Charité University Medicine Berlin, Berlin, Germany.
authors: Tadeus
authors: T
authors: Nawka
authors: Department of Otorhinolaryngology, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany.
authors: Christian
authors: C
authors: Sittel
authors: Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria.
authors: Markus
authors: M
authors: Gugatschka
authors: Department of Otorhinolaryngology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors: Christoph
authors: C
authors: Arens
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.
authors: Ruth
authors: R
authors: Lang-Roth
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Giessen and Marburg, Giessen, Germany.
authors: Claus
authors: C
authors: Wittekindt
authors: Department of Otorhinolaryngology, University of Wuerzburg, Wuerzburg, Germany.
authors: Rudolf
authors: R
authors: Hagen
authors: Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany.
authors: Andreas H
authors: AH
authors: Müller
authors: Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
authors: Gerd F
authors: GF
authors: Volk
authors: Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
authors: Orlando
authors: O
authors: Guntinas-Lichius
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D055815:Young Adult
keywords: Bilateral vocal fold paralysis; prospective study; transoral approach; treatment outcome