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- Title
Permanent transoral surgery of bilateral vocal fold paralysis: A prospective multi-center trial.
- Authors
Nawka, Tadeus; Sittel, Christian; Gugatschka, Markus; Arens, Christoph; Lang‐Roth, Ruth; Wittekindt, Claus; Hagen, Rudolf; Müller, Andreas H.; Volk, Gerd F.; Guntinas‐Lichius, Orlando
- Abstract
Objectives/Hypothesis To describe postoperative adverse events (AEs) and outcomes after transoral surgery for bilateral vocal fold paralysis (BVFP). Study Design Prospective observational multicenter study. Methods Thirty-six patients with BVFP underwent transoral surgery using standard surgical procedures to unilaterally widen the glottic area. Postoperative adverse events (AEs) including severe adverse events (SAEs) were registered continuously. Pre- and 6-month postoperative evaluations included the 6-Minute Walk Test, the 36-Item Short Form Health Survey (SF-36), the Glasgow Benefit Inventory, the 12-Item Voice Handicap Index (VHI-12), and a Fiberoptic Endoscopic Evaluation of Swallowing graded according to the Penetration-Aspiration-Scale. Results The patients underwent posterior cordotomy, partial arytenoidectomy, or permanent laterofixation as single procedures or in combination. Forty-seven percent of the patients had postoperative AEs. Dyspnea was the most frequent AE (45%). In 40% of AEs, the events were severe (SAEs), and 72.5% were related to the study intervention. Revision surgery leading to prolonged hospitalization or rehospitalization was necessary in nine cases (25%). Laterofixation was correlated to a decreased risk of AEs ( P = 0.042). Six months after surgery, a significant improvement was seen in the SF-domains: Physical component score ( P = 0.008), physical functioning ( P = 0.001), physical role ( P = 0.031), and vitality ( P = 0.032). Concerning the voice handicap, only the VHI-12 physical subscore showed a decrease ( P = 0.005). The total score and other VHI-12 subscores did not change significantly (all P > 0.05). Conclusion BCVP patients profit from modern transoral surgery for unilateral glottic widening; quality of life is improved; and the voice is preserved. Nevertheless, postoperative complications are frequent. Level of Evidence 2b. Laryngoscope, 125:1401-1408, 2015
- Subjects
VOCAL cord diseases; PARALYSIS; ADVERSE health care events; SPINAL cord surgery; ARYTENOIDECTOMY; QUALITY of life; THERAPEUTICS
- Publication
Laryngoscope, 2015, Vol 125, Issue 6, p1401
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.25137