[Combined endoscopic and external cordopexy in the treatment of post-thyroidectomy recurrent paralysis]

Bilateral adducted recurrent paralysis is a serious complication of thyroid surgery. The management of such conditions is a real challenge for ENT surgeons. Combined endoscopic and external cordopexy offers a way to alleviate laryngeal dyspnea and restore acceptable voice quality while preserving the anatomical integrity of laryngeal structures. From January 2012 to April 2023, we conducted a cross-sectional descriptive observational study with retrospective data collection, including 7 patients with bilateral post-thyroidectomy recurrent paralysis who had undergone combined cordopexy. Outcomes were assessed using the Likert satisfaction scale. All patients were female, with a mean age of 49 years. Dyspnea was observed in all patients. Nasofibroscopy showed paramedian adduction of the vocal cords in 4 cases and median adduction in 3 cases. Combined cordopexy was performed on the right in 42.9% of cases and on the left in 57.1%. Patient satisfaction, assessed using the Likert scale, showed that, in terms of respiratory outcomes, 2 patients were very satisfied and 3 were satisfied. One patient was very satisfied and 3 were satisfied with the quality of their voice. Two patients were not satisfied with their breathing. Combined endoscopic and external cordopexy is a simple, reversible, minimally invasive technique that can be used, in the management of bilateral post-thyroidectomy recurrent paralysis, with satisfactory results.