Reversible Lateralization of the Paralyzed Vocal Cord without Tracheostomy

Lichtenberger, György

doi:10.1177/000348940211100104

Cited by 75 publications

(55 citation statements)

References 16 publications

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“…Suture lateralization of a VF can be performed as a temporary measure to improve the airway during the period after injury where long-term outcome is uncertain. 238 Permanent treatments include posterior transverse cordotomy or arytenoid reduction and removal procedures. 239 SLN paralysis and paresis are more difficult to both recognize and treat.…”

mentioning

confidence: 99%

Clinical Practice Guideline: Improving Voice Outcomes after Thyroid Surgery

Chandrasekhar

Randolph

Seidman³

et al. 2013

Otolaryngol.--head neck surg.

355

100

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Objective. Thyroidectomy may be performed for clinical indications that include malignancy, benign nodules or cysts, suspicious findings on fine needle aspiration biopsy, dysphagia from cervical esophageal compression, or dyspnea from airway compression. About 1 in 10 patients experience temporary laryngeal nerve injury after surgery, with longer lasting voice problems in up to 1 in 25. Reduced quality of life after thyroid surgery is multifactorial and may include the need for lifelong medication, thyroid suppression, radioactive scanning/treatment, temporary and permanent hypoparathyroidism, temporary or permanent dysphonia postoperatively, and dysphagia. This clinical practice guideline provides evidence-based recommendations for management of the patient's voice when undergoing thyroid surgery during the preoperative, intraoperative, and postoperative period.Purpose. The purpose of this guideline is to optimize voice outcomes for adult patients aged 18 years or older after thyroid surgery. The target audience is any clinician involved in managing such patients, which includes but may not be limited to otolaryngologists, general surgeons, endocrinologists, internists, speech-language pathologists, family physicians and other primary care providers, anesthesiologists, nurses, and others who manage patients with thyroid/voice issues. The guideline applies to any setting in which clinicians may interact with patients before, during, or after thyroid surgery. Children under age 18 years are specifically excluded from the target population; however, the panel understands that many of the findings may be applicable to this population. Also excluded are patients undergoing concurrent laryngectomy. Although this guideline is limited to thyroidectomy, some of the recommendations may extrapolate to parathyroidectomy as well.Results. The guideline development group made a strong recommendation that the surgeon should identify the recurrent laryngeal nerve(s) during thyroid surgery. The group made recommendations that the clinician or surgeon should (1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery; (2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, if the patient's voice is impaired and a decision has been made to proceed with thyroid surgery; (3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery if the patient's voice is normal and the patient has (a) thyroid cancer with suspected extrathyroidal extension, or (b) prior neck surgery that increases the risk of laryngeal nerve injury (carotid endarterectomy, anterior approach to the cervical spine, cervical esophagectomy, and prior thyroid or parathyroid surgery), or (c) both; (4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery; (5) inform the anesthesi...

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mentioning

confidence: 99%

Clinical Practice Guideline: Improving Voice Outcomes after Thyroid Surgery

Chandrasekhar

Randolph

Seidman³

et al. 2013

Otolaryngol.--head neck surg.

355

100

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“…In described group 9 patients underwent tracheostomy procedure only one was without it. Lichtenberger suggested that endoscopic vocal cord lateral fixation would avoid the need for tracheostomy in cases of bilateral vocal cord paralysis [10]. But in our group in 5 cases unilateral laterofixation of vocal cord was unsuccessful as a first stage of surgical treatment of bilateral vocal cords.…”

Section: Discussionmentioning

confidence: 55%

Endoscopic laterofixation in bilateral vocal cords paralysis in children

Zawadzka-Głos

Frackiewicz

Chmielik

2010

International Journal of Pediatric Otorhinolaryngology

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“…A key advantage to early laterofixation is avoidance of a tracheostomy in patients with acute bilateral vocal fold paralysis [19,[21][22][23]. In 1993, Ejnell and Tisell [21] introduced the concept of acute temporary laterofixation for the treatment of bilateral vocal cord paralysis as an alternative to tracheostomy.…”

Section: Early Versus Late Laterofixationmentioning

confidence: 99%