Evaluation of the lung function test in reversible glottis-dilating operations.

Area of Science:

• Otolaryngology
• Pulmonology
• Surgical Innovation

Background:

• Bilateral abductor vocal cord paralysis is a common complication of thyroid surgery.
• Vocal cord paralysis can be reversible within the first six months post-surgery.
• Tracheostomy is a traditional treatment, but reversible glottis-dilating operations offer an alternative.

Purpose of the Study:

• To objectively evaluate airway function before and after reversible glottis-dilating operations.
• To quantitatively assess the functional outcomes of a specific endoscopic vocal cord laterofixation technique.
• To compare the efficacy of glottis-dilating methods using lung function tests.

Main Methods:

• Endoscopic vocal cord laterofixation using high-frequency JET ventilation and Lichtenberger's endo-extralaryngeal suture technique.
• Lung function tests including forced inspiratory volume (FIV1), forced expiratory volume (FEV1), peak inspiratory flow rate (PIF), peak expiratory flow rate (PEF), and airway resistance (Raw).
• Body-pletysmography was utilized for functional evaluation in 23 non-selected patients.

Main Results:

• Average forced expiratory volume (FEV1) improved by 25%.
• Average forced inspiratory volume (FIV1) improved by 39%.
• Peak inspiratory flow rate (PIF) and peak expiratory flow rate (PEF) improved by 45% and 37%, respectively. Airway resistance (Raw) decreased from 271.5% to 200.6%.

Conclusions:

• Reversible glottis-dilating surgery, specifically vocal cord laterofixation, is an effective alternative to tracheostomy for managing bilateral abductor vocal cord paralysis.
• The procedure leads to significant objective improvements in airway patency and lung function.
• Lung function tests provide a reliable method for quantitative evaluation of surgical outcomes in these patients.