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Surgical Management of Bilateral Abductor Palsy: Comparative Study Between Posterior Cordotomy and Partial Arytenoidectomy

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Abstract

The aim of this study is to analyse outcome of patients with bilateral abductor palsy undergoing unilateral partial arytenoidectomy and unilateral posterior cordotomy in terms of respiration, phonation and risk of aspiration. Initially tracheostomy was only treatment available to relieve respiratory distress. Now various methods are described e.g. endoscopic posterior cordotomy, arytenoidectomy, suture lateralization of vocal cords, laryngeal reinnervation and muscle transfer procedures. In our study, review of management of 21 cases of bilateral abductor palsy were carried out. Patient assessment included fibre optic laryngoscopy and radiology. Unilateral partial arytenoidectomy was carried out in 9 patients and unilateral posterior cordotomy was carried out in 12 patients. All the 21 cases in our study were tracheotomised. Among the 21 surgically treated patients 90.5% patients were decannulated. The mean increase in VHI 10 score after surgery was of 4.8. The mean increase was 4 in the partial arytenoidectomy group, whereas the mean increase in the posterior cordotomy group was 5. There was no history of aspiration following surgery. The percentage of cases requiring revision surgery was 33% in patients undergoing partial arytenoidectomy and was 25% in patients undergoing posterior cordotomy. Analysis of results after 12 months revealed that both unilateral posterior cordotomy and unilateral partial arytenoidectomy are effective and satisfactory procedures in treatment of bilateral abductor palsy.

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Authors and Affiliations

  1. Guru Teg Bahadur Hospital, New Delhi, India

    Deepika Vajpayee, Divya Vaid, Richa Saha & Arun Goyal

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  1. Deepika Vajpayee
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  2. Divya Vaid
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  3. Richa Saha
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  4. Arun Goyal
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Correspondence to Deepika Vajpayee.

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All procedures performed were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Vajpayee, D., Vaid, D., Saha, R. et al. Surgical Management of Bilateral Abductor Palsy: Comparative Study Between Posterior Cordotomy and Partial Arytenoidectomy. Indian J Otolaryngol Head Neck Surg 73, 340–345 (2021). https://doi.org/10.1007/s12070-021-02556-2

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  • DOI: https://doi.org/10.1007/s12070-021-02556-2

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