The present study was conducted to evaluate the endoscopic carbon
dioxide laser as a method for treatment of patients suffering from bilateral
abductor paralysis by comparing the results of two different surgical procedures.
Forty patients with bilateral abductor paralysis following thyroidectomy
operation were included in the study. Patients were operated
upon by two surgical procedures using laser. Arytenoidectomy was performed
to patients of group A (22 patients) and transverse cordotomy was
performed to pateints of group B (18 patients) .
In group A (55% of all patients) the overall success rate was 73% ( 1 6
out of 22 patients) Four patients ( I 8%)did not improve and were discharged
with a tracheostomy. Aspiration was noticed in 2 patients (9%)
immediately after arytenoidectomy and disharged with a tracheostomy
tube .In group B (45% of all patients) the overall success rate was 66%
(14 out of 18 patients). Four patients did not improve and were discharged
with tracheostomy tubes. Two of these patients had previous cordopery
without improvement and the other two were suffering from chest troubles
in the form of chronic chest infection .
Minimal voice loss occurs in this series and voice quality continues to
improve 6 months postoperatively with voice therapy. There were no
swallowing impairment, aspiration or cough- chock episodes. It could be
concluded that endoscopic laser arytenoidectomy and transverse cordotomy
are nearly equally effective and reliable in the management of the restricted
airway and both maintained a good voice quality |
