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Adjustable laterofixation of the vocal fold in bilateral vocal fold paralysis
Author(s) -
Ezzat Waleed F.,
Shehata Mohammed,
Kamal Ihab,
Riad Magdy Amin
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20826
Subject(s) - medicine , vocal fold paralysis , airway , surgery , thyroid cartilage , tracheotomy , swallowing , recurrent laryngeal nerve , vocal cord paralysis , breathing , anesthesia , paralysis , larynx , thyroid
Objectives/Hypothesis: To describe a modification of VF laterofixation in patients with bilateral vocal fold paralysis (VFP), which allows adjusting the sutures tension according to voice and airway patency in the first postoperative day. Study Design: Prospective case study. Methods: Twenty‐one patients with recent bilateral VFP were treated by the modified laterofixation technique in Ain‐Shams University hospitals between May 2007 and February 2009. Eight male patients and 13 females were included. The median age of the group was 36 years. The standard laterofixation procedure was performed; the Prolene sutures were inserted through the thyroid ala cartilage and looped around the paralyzed VF just anterior to the vocal process. The ultimate tension of the suture was adjusted later in the first postoperative day to gain feedback from the conscious patient about the airway patency and voice quality. Results: Satisfactory immediate result was achieved in 16 patients, with adequate airway, voice, and swallowing. Three other patients required bilateral procedures, one patient needed revision surgery. The procedure failed to achieve a satisfactory airway in one patient who remained dependant on a tracheotomy. Conclusions: The modified laterofixation technique is a reliable first line treatment for recent bilateral VFP. Laryngoscope, 2010