title: Possibilities of surgical correction of vocal cord palsy after thyroid gland operations.
abstract: BACKGROUND
  Surgery of the thyroid gland remains the main cause of bilateral vocal cord palsy (VCP). Ventilation problem is the main problem in such situations. There are a couple of corrective surgical procedures in the case of VCP. The aim of our study was to show the possibility of widening of the glottis, and to evaluate the techniques and effects of surgical treatments due to bilateral VCP resulting from thyroid gland surgery.
  
  
  METHODS
  Five methods of surgical treatment were used: laser-assisted posterior cordectomy, according to Denis and Kashima; laser-assisted bilateral medial arytenoidectomy, as proposed by Crumley; laser-assisted posterior ventriculocordectomy, as described by Pia; laser-assisted total arytenoidectomy with posterior cordectomy, as presented by Ossoff; and laterofixation, according to Lichtenberger. The postoperative patient's subjective improvement was assessed using visual analogue scale.
  
  
  RESULTS
  Between 1998 and 2014 we operated on 270 patients with bilateral VCP. Paresis occurred as the result of the iatrogenic effect of thyroid gland surgery in 255 patients (94.4%) vs. 15 (7.6%) from other causes. The majority of our patients (77.6%) had undergone laser arytenoidectomy with posterior partial cordectomy, and in 13.7% of them Lichtenberger laterofixation had been performed. Ossoff 's surgery gives good ventilation results: successful decannulation (62.9% after first surgery; 97.6% final rate) and significant subjective ventilation improvement in 96% of patients.
  
  
  CONCLUSIONS
  Ossoff 's laser arytenoidectomy with posterior cordectomy is a safe procedure that gives acceptable ventilation improvement. Patients report satisfactory quality of life and the possibility of returning to active professional life. Laterofixation should be considered as an alternative for tracheotomy rather than permanent procedure.
authors.forename: Grazyna
authors.initials: G
authors.lastname: Lisowska
authors.affiliation: ENT Department, Medical University of Silesia, Zabrze, Poland. paw.sowa@gmail.com.
authors.forename: Pawel
authors.initials: P
authors.lastname: Sowa
authors.forename: Hanna
authors.initials: H
authors.lastname: Misiolek
authors.forename: Wojciech
authors.initials: W
authors.lastname: Scierski
authors.forename: Maciej
authors.initials: M
authors.lastname: Misiolek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013507:Endocrine Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013961:Thyroid Gland / Q000601:surgery*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000601:surgery; D055815:Young Adult
keywords: arytenotidectomy; laterofixation; mytomicin-C; thyroid gland surgery complication; vocal cord palsy; vocal cord paralysis