Abstract
The purpose of this report is to describe the anaesthetic considerations for layngoplastic procedures. Thyroplasty is a procedure which restores the voice in unilateral vocal cord paralysis. The procedure employs an external approach via a window cut at the appropriate level in the thyroid ala. A wedge of silastic is inserted against the inner perichondrium, thereby displacing the vocal cord medially and permitting voice production. Correct placement of the implant is assessed by asking the patient to phonate; patient cooperation is therefore necessary at certain times during the procedure. We describe our management of a patient undergoing thyroplasty. The use of a benzodiazepine agonist-antagonist combination provided both optimal operating conditions and patient comfort.
Résumé
Pour l’anesthésie, les interventions de reconstruction laryngée présentent des problèmes particuliers. La thyroplastie est une intervention qui permet de rétablir la phonation dans les cas de paralysie d’une corde vocale. Pour réaliser cette intervention, il faut pratiquer de l’extérieur une fenêtre au niveau de l’aile thyroïdienne. Un coin de sylastic est inséré près du périchondre interne pour déplacer la corde vocale vers la ligne médiane et rétablir la phonation. La position correcte de l’implant est déterminée par la phonation extemporanée: la collaboration du patient s’avère donc essentielle pendant l’intervention. Les auteurs décrivent la ligne de conduite qu’ils ont adoptée pour la thyroplastie. L’association de benzodiazepines agonisteantagoniste a assuré des conditions opératoires optimales et le confort au patient.
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Donnelly, M., Browne, J. & Fitzpatrick, G. Anaesthesia for thyroplasty. Can J Anaesth 42, 813–815 (1995). https://doi.org/10.1007/BF03011184
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DOI: https://doi.org/10.1007/BF03011184