Efficacy and Safety of Acute Injection Laryngoplasty for Vocal Cord Paralysis Following Thoracic Surgery

被引:51
作者
Graboyes, Evan M. [1 ]
Bradley, Joseph P. [1 ]
Meyers, Bryan F. [2 ]
Nussenbaum, Brian [1 ]
机构
[1] Washington Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, St Louis, MO 63110 USA
[2] Washington Univ, Sch Med, Div Cardiothorac Surg, Dept Surg, St Louis, MO 63110 USA
关键词
Injection laryngoplasty; vocal cord; vocal cord paralysis; RECURRENT NERVE PARALYSIS; FOLD PARALYSIS; MEDIALIZATION; ESOPHAGECTOMY; CARCINOMA; OUTCOMES; CANCER;
D O I
10.1002/lary.22178
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/Hypothesis: The primary objective of this study was to evaluate the effectiveness and safety of injection laryngoplasty using a temporary injectable agent in the acute setting for patients with unilateral vocal cord paralysis following thoracic surgical procedures. Study Design: Retrospective consecutive case series in an academic institution. Methods: Inclusion criteria included patients acutely treated with injection laryngoplasty from January 1, 2006, to March 31, 2010, for a unilateral vocal cord paralysis that occurred after a thoracic surgical procedure (N = 20). All patients were injected with Radiesse Voice Gel using microlaryngoscopy technique. Results: The mean time to vocal cord injection from the time of thoracic surgery was 4.5 days. There was one operative-related complication of intraoperative bile reflux that caused a pneumonitis. Ninety percent of patients were recommended for strict nothing by mouth prior to injection. Of these, 94% were allowed an oral diet following injection, and 67% tolerated a regular diet. None of the patients required subsequent procedures for aspiration or dysphagia, and 25% required further intervention after discharge for persistent dysphonia. Patients with a known nerve transection had a higher rate of dysphonia requiring further surgical procedures than those who did not have a known nerve transection. Conclusions: Acute treatment of thoracic surgery-related unilateral vocal cord paralysis with injection laryngoplasty appears safe and effective at preventing postoperative aspiration pneumonia and improves swallowing function to allow resumption of an oral diet. A single injection is often the only required treatment.
引用
收藏
页码:2406 / 2410
页数:5
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