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Vocal Fold Paralysis After Anterior Cervical Diskectomy and Fusion
Author(s) -
Morpeth James F.,
Williams Mark F.
Publication year - 2000
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 - 10.1097/00005537-200001000-00009
Subject(s) - medicine , dysphagia , surgery , stridor , anterior cervical discectomy and fusion , complication , medical record , swallowing , paralysis , diskectomy , vocal cord paralysis , cervical spine , lumbar , lumbar vertebrae , airway
Objective: The anterior approach to the cervical spine now serves as the surgical access of choice for cervical spine disease. Vocal fold paralysis (VFP) may follow the procedure as a complication. The authors describe their experience with patients having VFP after anterior cervical diskectomy and fusion (ACDF), with an emphasis on outcome and prognosis. Study Design: Retrospective. Methods: Medical records of patients who underwent ACDF between January 1987 and February 1998 were reviewed. Further detailed review of the patients with documented VFP after surgery was then performed. Results: Over the given time period 411 ACDFs were performed and 21 patients with this complication were identified (5%). All 21 patients had right‐sided approaches. Eighteen patients had right VFP, 2 had left VFP, and 1 had bilateral VFP. Symptoms included hoarseness (18), persistent cough (7), aspiration (13), and dysphagia (7). The patient with bilateral VFP presented with stridor and respiratory distress requiring tracheotomy. The complete records of 17 patients with 18 VFPs were available for review. Fifteen of 18 VFPs (83.3%) had complete resolution within 12 months. One patient had recovery after 15 months. All patients were treated conservatively with speech and swallowing therapy. One patient required Gelfoam injection and another medialization thyroplasty, both for aspiration symptoms. Conclusions: The data suggest that at least 80% of VFP after ACDF will recover within 12 months of the procedure. The authors recommend regular follow‐up and speech therapy for symptomatic patients. Medialization should be considered in patients with aspiration or persistent problems.