Total and Partial Laser Arytenoidectomy for Bilateral Vocal Fold Paralysis.
Introduction. Treatment for bilateral vocal fold paralysis (BVFP) has evolved from external irreversible procedures to endolaryngeal laser surgery with greater focus on anatomic and functional preservation. Since the introduction of endolaryngeal laser arytenoidectomy, certain modifications have been described, such as partial resection procedures and mucosa sparing techniques as opposed to total arytenoidectomy.Discussion. The primary outcome measure in studies on BVFP treatment using total or partial arytenoidectomy is avoidance of tracheotomy or decannulation and reported success ranges between 90 and 100% in this regard. Phonation is invariably affected and arytenoidectomy worsens both aerodynamic and acoustic vocal properties. Recent reports indicate that partial and total arytenoidectomies have similar outcome in respect to phonation and swallowing. We use CO2laser assisted partial arytenoidectomy with a posteromedially based mucosal flap for primary cases and reserve total arytenoidectomy for revision. Lateral suturing of preserved mucosa provides tension on the vocal fold leading to better voice and leaves no raw surgical field to unpredictable scarring or granulation.Conclusion. Arytenoidectomy as a permanent static procedure remains a traditional yet sound choice in the treatment of BVFP. Laser dissection provides a precise dissection in a narrow surgical field and the possibility to perform partial arytenoidectomy.
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Taner
0000-0001-8999-3237
T
Yılmaz
Department of Otolaryngology-Head and Neck Surgery, Ankara Numune Research and Training Hospital, Ankara, Turkey.
Ozan Muzaffer
0000-0002-8747-7420
OM
Altuntaş
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Nilda
N
Süslü
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Gamze
G
Atay
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Serdar
S
Özer
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Oğuz
O
Kuşçu
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Tevfik
T
Sözen
D003679:Deglutition; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D010699:Phonation; D020127:Recovery of Function; D014826:Vocal Cord Paralysis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery