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Methods of surgical treatment of bilateral vocal fold paralysis.

Authors
  • Czesak, Małgorzata A1
  • Osuch-Wójcikiewicz, Ewa2
  • Niemczyk, Kazimierz2
  • 1 Chair and Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland, Poland. [email protected] , (Poland)
  • 2 Chair and Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland, Poland. , (Poland)
Type
Published Article
Journal
Endokrynologia Polska
Publication Date
Jan 01, 2020
Volume
71
Issue
4
Pages
350–358
Identifiers
DOI: 10.5603/EP.a2020.0042
PMID: 32852048
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Bilateral vocal fold paralysis presents as their complete or partial immobilisation. The median or paramedian position of vocal folds contributes to the narrowing of the airway at the level of the glottis and manifests as inspiratory dyspnoea. For many years iatrogenic injury of recurrent laryngeal nerves during thyroidectomy has been viewed as the most common underlying reason. It is very often a lifethreatening condition requiring not only corticosteroid administration and intubation, which only constitute a short-term symptomatic therapy, but also surgical intervention, including tracheostomy. The most common surgical methods implemented in bilateral vocal fold paralysis include posterior cordectomy, arytenoidectomy, and, more and more commonly, re-innervation. Other techniques used in restoring airway patency include laterofixation, botulinum toxin injection, and laryngeal stimulation, which is still under research. Stem cell and gene therapy are also being researched. Notably, the main purpose of surgical treatment is the provision of airway patency with the preservation of the phonatory and protective functions of the larynx.

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