Laser arytenoidectomy and posterior cordotomy in a patient with bilateral vocal cord paralysis due to multiple system atrophy.
Bilateral vocal cord paralysis leading to stridor is a known but rare complication of Parkinson's disease (PD) and a recognised complication of multiple system atrophy (MSA). Tracheostomy is a commonly offered treatment, leading to substantial adaptations and lifestyle changes for the patient. Patients can struggle to manage a tracheostomy due to the tremor and bradykinesia associated with their parkinsonism. We report a case of bilateral vocal cord paralysis leading to significant stridor in a patient with atypical parkinsonism (probable MSA). To avoid tracheostomy, our patient underwent successful right-sided laser arytenoidectomy and posterior cordotomy as a day-case procedure. At follow-up, he had a weaker voice but complete recovery from the shortness of breath and stridor. He was very satisfied with the outcome. We conclude that, despite resulting in a weaker voice, this procedure offers an option to the patient that improves quality of life.
ENT Department, University Hospital Coventry & Warwickshire, Coventry, UK.
Ayesha
A
Mahmud
Neurology Department, University Hospital Coventry & Warwickshire, Coventry, UK.
Lucy H A
LH
Strens
ENT Department, University Hospital Coventry & Warwickshire, Coventry, UK ENT University Department, Medical School of Comenius University, Bratislava, Slovakia.
Miroslav
M
Tedla
D000368:Aged; D001193:Arytenoid Cartilage / Q000601:surgery; D002818:Cordotomy / Q000379:methods*; D006801:Humans; D007825:Laryngectomy / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods; D053685:Laser Therapy / Q000379:methods; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D019578:Multiple System Atrophy / Q000150:complications*; D011788:Quality of Life; D012135:Respiratory Sounds / Q000209:etiology*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000150:complications / Q000209:etiology / Q000601:surgery*