Abstract
During the 15-year period from 1978 to 1993 we treated 17 cannulated patients suffering from dyspnea caused by bilateral recurrent laryngeal nerve palsies. The causes of palsy were struma surgery (13 cases), prolonged intubation (3 cases) and unknown (1 case). All cases were operated on by the classical endolaryngeal arytenoidectomy technique developed by Kleinsasser. All patients were able to be decanulated after arytenoidectomy: 14 cases within I month of surgery and 3 delayed. Four patients required replacements of their tracheotomies during the follow-up period, but this proved to be only temporary in 3 cases. After excisions of polypoid tissues or enlargement of an ipsilateral partial cordectomy, definitive closure of the tracheostome was possible. Among the retracheotomized patients, only 1 patient with multilocular stenoses has remained under treatment for the past 2 years. In all, 16 of 17 patients (93%) have remained permanently decannulated.
Similar content being viewed by others
References
Chazly M el, Rifai M, Ezz AA el (1991) Arytenoidectomy and posterior cordectomy for bilateral abductor paralysis. J Laryngol Otol 105:454–455
Ejnell H, Mansson I., Hallen O, Bake B, Stemborg R, Lindström J (1994) A simple operation for bilateral vocal cord paralysis. Laryngoscope 94:954–958
Greisen O, Nabe-Nielsen J (1990) Bilateral paralysis of the vocal cords treated with endolaryngeal arytenoidectomy. Ugeskr Laeger 152:1228–1229
Holl-Allen RT (1986) A new approach to the surgical management of paralysis of the laryngeal nerve after thyreoidectomy. Surg Gynekol Obstet 163:543–546
Kleinsasser O, Nolte E (1981) Endolaryngeale Arytenoidektomie and submukose partielle Chordektomie bei bilateralen Stimmlippenlähmungen. Laryngol Rhinol 60:397–401
Lannigan FJ, Robb PJ, Alderson DJ, Shaheen OH (1992) CO2 laser cordectomy in management of bilateral vocal cord paralysis. J R Coll Surg Edinb 36:378–380
Lim RY (1985) Laser arytenoidectomy. Arch Otolaryngol 111:262–263
Moustafa H, Guindy A el, Sherief S el, Targam A (1992) The role of endoscopic laterofixation of the vocal cord in the treatment of bilateral abductor paralysis. J Laryngol Otol 106: 31–34
Nassar WY, Sadek AS, Baraka ME, Jones PH (1985) Intralaryngeal arytenoidectomy. A report of six cases. J Laryngol Otol 99:513–516
Ossoff RH, Duncavage JA, Shapshay SM, Krespi YP, Sisson GA Sr (1990) Endoscopic laser arytenoidectomy revisited. Ann Otol Rhinol Laryngol 99:764–771
Ossoff RH, Sisson GA, Duncavage JA, Moselle HI, Andrews PE, McMillan WB (1984) Endoscopic laser arytenoidectomy for treatment of bilateral vocal cord paralysis. Laryngoscope 94:1293–1297
Plch J (1994) A simple instrument for endoscopic laryngeal and pharyngeal suturing. Eur Arch Otorhinolaryngol 251:373–374
Prasad U (1985) CO2 surgical laser in the management of bilateral vocal cord paralysis. J Laryngol Otol 99:891–894
Rontal M, Rontal E (1990) Endoscopic laryngeal surgery for bilateral midline vocal cord obstruction. Ann Otol Rhinol Laryngol 99:605–610
Thornell WC (1948) Intralaryngeal approach for arytenoidectomy in bilateral abductor vocal cord paralysis. Arch Otolaryngol 47: 505–508
Tucker HM (1989) Long term results of nerve-muscle pedicle reinnervation for laryngeal paralysis. Ann Otol Rhinol Laryngol 98:674–676
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Plch, J., Navrátilová, I. Severe functional laryngeal stenoses treated by endoscopic arytenoidectomy. Eur Arch Otorhinolaryngol 253, 39–41 (1996). https://doi.org/10.1007/BF00176701
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00176701