The assistance of coblation in arytenoidectomy for vocal cord paralysis

Hu, Yuqiang; Cheng, Liangjun; Liu, Bing; Ming, Hao; Tian, Aimin; Ma, Mei

doi:10.1080/00016489.2018.1542160

Cited by 12 publications

(20 citation statements)

References 16 publications

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“…Many endoscopic procedures have been debated in pediatric patients, such as posterior cordotomy, [12] arytenoidopexy, [13] vocal cord lateralization, [14] and anterior–posterior cricoid split, [15,16] but there is still no ideal solution for all BVCP problems. In the past 10 years, a few studies have focused on the combination of coblator and arytenoidectomy in the management of BVCP in adults and older infants [8,17] . To our knowledge, this is the first report to discuss this procedure with regard to infants.…”

Section: Discussionmentioning

confidence: 95%

“…In the past 10 years, a few studies have focused on the combination of coblator and arytenoidectomy in the management of BVCP in adults and older infants. [ 8 , 17 ] To our knowledge, this is the first report to discuss this procedure with regard to infants. Arytenoidectomy is generally performed by removing the arytenoid cartilage together with the mucosa, which carries the risk of granuloma and scar formation.…”

Section: Discussionmentioning

confidence: 98%

“…[ 18 ] In a recent study, Hu reported that 13 of 14 patients (93%) underwent removal of the tracheal tube safely within 1 month after coblation-assisted partial arytenoidectomy. [ 8 ] In this study, with an overall success rate of 88%, we consider that ECPA is a reasonable and acceptable procedure. Our findings illustrated that ECPA had a promising outcome in swallowing function and voice, attributed to the minor excision range and preservation of the height of the arytenoid.…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 ] Since it is safe and efficient, a coblator has been employed to perform partial arytenoidectomy in some studies. [ 8 , 9 ]…”

Section: Introductionmentioning

confidence: 99%

“…[7] Since it is safe and efficient, a coblator has been employed to perform partial arytenoidectomy in some studies. [8,9] In this study, we describe the utility and outcomes of endoscopic coblation-assisted and partial arytenoidectomy (ECPA) in infants with idiopathic BVCP and discuss the feasibility and efficacy of this procedure.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic coblation-assisted and partial arytenoidectomy for infants with idiopathic bilateral vocal cord paralysis

Tan

Chen²,

Li³

2022

Medicine

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To review our experience with endoscopic coblation-assisted and partial arytenoidectomy (ECPA) in treating idiopathic bilateral vocal cord paralysis (BVCP). A retrospective analysis of thirty-three infants (19 boys and 14 girls, aged 1–10 months) with idiopathic BVCP undergoing ECPA was performed. The therapeutic process and outcomes (surgical success, swallowing function, and voice) were reviewed. The follow-up period was >33 months. Among the thirty-three infants with idiopathic BVCP, surgery was successful in twenty-nine cases but failed in four cases. Twenty-one, nine, and three patients underwent right, left, and bilateral ECPA, with surgical success rates of 90.5%, 100.0%, and 33.3%, respectively. In addition, four and six cases were combined with subglottic stenosis (SGS) and laryngomalacia, respectively. The surgical success rates of BVCP alone and BVCP+ other airway abnormalities were 95.6% and 70.0%, respectively. During the follow-up, five infants had slight difficulty swallowing, 12 infants had partial or complete recovery movement of at least one vocal cord with satisfactory voice outcome, and five infants had early granuloma formation, which disappeared spontaneously. ECPA appears to be a promising alternative to tracheostomy and initial management in infants with idiopathic BVCP who are free of other airway abnormalities.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

“…[ 7 ] Since it is safe and efficient, a coblator has been employed to perform partial arytenoidectomy in some studies. [ 8 , 9 ]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic coblation-assisted and partial arytenoidectomy for infants with idiopathic bilateral vocal cord paralysis

Tan

Chen²,

Li³

2022

Medicine

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Management of Bilateral Vocal Fold Paralysis: A Systematic Review

Lechien,

Hans,

Mau

2023

Otolaryngol.--head neck surg.

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ObjectiveTo review the current literature about epidemiology, etiologies and surgical management of bilateral vocal fold paralysis (BVFP).Data SourcesPubMED, Scopus, and Cochrane Library.Review MethodsA systematic review of the literature on epidemiology, etiologies, and management of adult patients with BVFP was conducted through preferred reporting items for systematic reviews and meta‐analyses statements by 2 investigators.ResultsOf the 360 identified papers, 245 were screened, and of these 55 were considered for review. The majority (76.6%) of BVFP cases are iatrogenic. BVFP requires immediate tracheotomy in 36.2% of cases. Laterofixation of the vocal fold was described in 9 studies and is a cost‐effective alternative procedure to tracheotomy while awaiting potential recovery. Unilateral and bilateral posterior transverse cordotomy outcomes were reported in 9 and 7 studies, respectively. Both approaches are associated with a 95.1% decannulation rate, adequate airway volume, but voice quality worsening. Unilateral/bilateral partial arytenoidectomy data were described in 4 studies, which reported lower decannulation rate (83%) and better voice quality outcome than cordotomy. Revision rates and complications vary across studies, with complications mainly involving edema, granuloma, fibrosis, and scarring. Selective posterior cricoarytenoid reinnervation is being performed by more surgeons and should be a promising addition to the BVFP surgical armamentarium.ConclusionDepending on techniques, the management of BVFP may be associated with several degrees of airway improvements while worsened or unchanged voice quality. The heterogeneity between studies, the lack of large‐cohort controlled randomized studies and the confusion with posterior glottic stenosis limit the draw of clear conclusion about the superiority of some techniques over others.

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