Long-term results in patients after combined laser total arytenoidectomy with posterior cordectomy for bilateral vocal cord paralysis
The problem of ventilation efficiency after total laser arytenoidectomy with posterior cordectomy due to bilateral vocal cord paralysis is discussed. There are a number of views on the usefulness and efficacy of different surgical procedures aimed at widening the glottis, but the studies concerning...
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Published in | European archives of oto-rhino-laryngology Vol. 264; no. 8; pp. 895 - 900 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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Berlin
Springer
01.08.2007
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Abstract | The problem of ventilation efficiency after total laser arytenoidectomy with posterior cordectomy due to bilateral vocal cord paralysis is discussed. There are a number of views on the usefulness and efficacy of different surgical procedures aimed at widening the glottis, but the studies concerning the long-term functional results are still lacking. The objective of the study is to evaluate the durability of ventilation results in patients after laser arytenoidectomy with posterior cordectomy based on the comparison between the early postoperative results and those assessed after a period of 5 years. Thirty patients (24 females, 6 males) aged between 30 and 80 (mean 58.5) with bilateral vocal cord paralysis after thyroid surgery, who underwent laser arytenoidectomy with posterior cordectomy, were analyzed. Ventilation tests were performed immediately after the operation and 5 years later with Body-Master Laab (Jaeger). The actual and predicted values of FVC, FEF(25), FEF(50), FEF(75), PEF, MMEF(75/25), AREA(Ex), sR(T0T), R(T0T) were compared and analyzed. Also, the values of the inspiratory parameters FIV(1), FIF(50), PIF and the coefficients FEF(50)/FIF(50) and FIV(1)/FEV(1) were assessed. Moreover, subjective evaluation was performed based on a questionnaire. The statistical analysis reveals a significant decrease in FIV(1), FIF(50), PIF and FIV(1)/FEV(1). FEF(50)/FIF(50) and sR(T0T) (actual and predicted values) increased significantly after 5 years from the operation. However, the patients did not complain nor was this tendency reflected in their answers to the questionnaire. The probable reasons for such ventilation results are discussed. The role of phoniatric rehabilitation and the time elapsed is emphasized. In general, it can be concluded that laser arytenoidectomy with posterior cordectomy is a durable and effective procedure, although the objective assessment does not fully match the patient's subjective impression. |
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AbstractList | The problem of ventilation efficiency after total laser arytenoidectomy with posterior cordectomy due to bilateral vocal cord paralysis is discussed. There are a number of views on the usefulness and efficacy of different surgical procedures aimed at widening the glottis, but the studies concerning the long-term functional results are still lacking. The objective of the study is to evaluate the durability of ventilation results in patients after laser arytenoidectomy with posterior cordectomy based on the comparison between the early postoperative results and those assessed after a period of 5 years. Thirty patients (24 females, 6 males) aged between 30 and 80 (mean 58.5) with bilateral vocal cord paralysis after thyroid surgery, who underwent laser arytenoidectomy with posterior cordectomy, were analyzed. Ventilation tests were performed immediately after the operation and 5 years later with Body-Master Laab (Jaeger). The actual and predicted values of FVC, FEF(25), FEF(50), FEF(75), PEF, MMEF(75/25), AREA(Ex), sR(T0T), R(T0T) were compared and analyzed. Also, the values of the inspiratory parameters FIV(1), FIF(50), PIF and the coefficients FEF(50)/FIF(50) and FIV(1)/FEV(1) were assessed. Moreover, subjective evaluation was performed based on a questionnaire. The statistical analysis reveals a significant decrease in FIV(1), FIF(50), PIF and FIV(1)/FEV(1). FEF(50)/FIF(50) and sR(T0T) (actual and predicted values) increased significantly after 5 years from the operation. However, the patients did not complain nor was this tendency reflected in their answers to the questionnaire. The probable reasons for such ventilation results are discussed. The role of phoniatric rehabilitation and the time elapsed is emphasized. In general, it can be concluded that laser arytenoidectomy with posterior cordectomy is a durable and effective procedure, although the objective assessment does not fully match the patient's subjective impression. |
Author | MISIOLEK, Hanna MISIOLEK, Maciej KUCIA, Jaroslaw SCIERSKI, Wojciech KOZIELSKI, Jerzy WARMUZINSKI, Krzysztof ZIORA, Dariusz NAMYSLOWSKI, Grzegorz |
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Cites_doi | 10.1177/000348949110000905 10.1007/s004050050170 10.1001/archotol.1985.00800060086013 10.1007/s004050050175 10.1177/000348940511400206 10.1007/s00405-003-0603-1 10.1007/s004050100370 10.1177/000348949310200201 10.1007/s004050050176 10.1177/000348949610500604 10.1007/s004050050248 10.1177/019459988309100317 10.1177/000348949009901002 10.1007/s004050100357 10.1177/000348948909801203 |
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Keywords | Human Nervous system diseases Arytenoidectomy Ventilation tests Motor system disorder Bilateral Long term Arytenoidectomy Vocal cord paralysis Laser Posterior ENT disease Ventilation Larynx disease Neurological disorder Cordectomy |
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Snippet | The problem of ventilation efficiency after total laser arytenoidectomy with posterior cordectomy due to bilateral vocal cord paralysis is discussed. There are... |
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SubjectTerms | Adult Aged Aged, 80 and over Arytenoid Cartilage - surgery Biological and medical sciences Female Follow-Up Studies Humans Laser Therapy - methods Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Nervous system as a whole Neurology Non tumoral diseases Otorhinolaryngologic Surgical Procedures - methods Otorhinolaryngology (head neck, general aspects and miscellaneous) Otorhinolaryngology. Stomatology Plethysmography Respiratory Function Tests Thyroidectomy - adverse effects Time Factors Treatment Outcome Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology Vocal Cord Paralysis - etiology Vocal Cord Paralysis - physiopathology Vocal Cord Paralysis - surgery Vocal Cords - physiopathology Vocal Cords - surgery |
Title | Long-term results in patients after combined laser total arytenoidectomy with posterior cordectomy for bilateral vocal cord paralysis |
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