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Published on: March 18, 2020
Suture lateralization in patients with bilateral vocal fold paralysis
Wan-Fu Su1, Shao-Cheng Liu2, Wei-Sheng Tang3
1Department of Otolaryngology-Head and Neck Surgery, Taipei Tzu Chi Hospital, Buddist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Tzu-Chi Univercity, Hualien, Taiwan, Republic of China; Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
A simplified suture lateralization (SL) technique effectively treated bilateral vocal fold paralysis (BVFP), improving respiration and voice quality in most patients. This minimally invasive procedure offers a reversible option for selected individuals.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Vocal Fold Dynamics
Background:
- Bilateral vocal fold paralysis (BVFP) presents significant challenges in airway management and phonation.
- Traditional surgical interventions for BVFP can be invasive and irreversible.
- A need exists for simpler, effective treatment options for BVFP.
Purpose of the Study:
- To introduce and evaluate a simplified suture lateralization (SL) technique for treating patients with bilateral vocal fold paralysis (BVFP).
- To assess the efficacy of SL in improving respiration and voice quality.
- To determine the safety and applicability of the SL procedure.
Main Methods:
- Retrospective chart review of 20 patients undergoing endoscopic SL for BVFP between 2007 and 2013.
- Evaluation of decannulation success, respiratory function (pulmonary function tests, flow-volume loops), and voice quality (phonatory tests, St George's respiratory questionnaire).
- Inclusion of adjustment procedures for managing post-operative symptoms like aspiration or breathiness.
Main Results:
- Successful respiration without artificial airways in 19 of 20 patients post-SL.
- Socially acceptable voice quality in 19 patients, with 14 achieving preoperative or better quality.
- Temporary mild aspiration in 18 patients; two adjustment procedures were needed for optimal outcomes.
Conclusions:
- Simplified suture lateralization (SL) is a simple, reversible, and minimally invasive surgical technique for BVFP.
- The SL procedure demonstrates applicability and effectiveness in selected patients with bilateral vocal fold paralysis.
- SL offers a viable reconstructive option for improving airway patency and voice function in BVFP patients.
