The assistance of coblation in arytenoidectomy for vocal cord paralysis

Abstract

Background: There are many causes for vocal cord paralysis, which can cause difficulty in breathing in serious cases. The common surgical methods for solving vocal cord paralysis include laryngeal splitting or laser surgery, but there are limitations. Plasma radiofrequency ablation is a new treatment with good achievements in clinical applications.

Objective: To investigate the effect of coblation-assisted arytenoidectomy (CSA) in the treatment of bilateral vocal cord paralysis (BVCP).

Methods: All patients had undergone preoperative electrolaryngoscopic examination of the glottidis rima; electronic laryngoscopy can assess the width of the glottis. The purpose of preoperative electronic laryngoscopic evaluation is to assess the width of the glottis, and arytenoid cartilage movement. Unilateral arytenoid cartilage and a section of the vocal cords were removed in all cases.

Results: Of the 14 patients, 13 were successfully extubated after CSA; 1 patient could not be extubated and underwent a second CSA of the contralateral arytenoid cartilage, after which extubation was achieved. All patients were continuously followed up (6 months to 2 years), and all achieved satisfactory results.

Conclusions and significance: CSA can effectively relieve post-CSA dyspnea in patients with BVCP. More patients underwent tracheal cannula extubation after tracheotomy compared with other surgeries.

Chinese abstract

背景：声带麻痹的原因很多, 严重的会导致呼吸困难。解决声带麻痹的常用手术方法有喉裂术或激光手术, 但都有局限性。等离子射频消融术是一种新的治疗方法, 在临床应用中取得了良好的效果。

目的：探讨应用低温消融下杓状软骨切除术（CSA）治疗双侧声带麻痹（BVCP）的疗效。

方法：所有患者术前均接受了电子喉镜检查；用电子喉镜可检测声门宽度。术前电子喉镜检查的目的是评估声门的宽度和杓状软骨的移动。所有病例均摘除单侧杓状软骨及一段声带。

结果：14例患者中, 13例在CSA之后成功拔管, 1例不能拔管。对这例患者进行第二次对侧杓状软骨切除术, 之后拔管成功。所有患者均接受连续随访（6个月至2年）, 并取得满意结果。

结论与意义：CSA可有效缓解BVCP患者CSA术后的呼吸困难。与其他手术相比, 更多患者在气管切开术后都经历气管插管拔管。

Keywords:

• Vocal cord paralysis
• laryngoscopy
• coblation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by The Science and Technology Innovation Projects of Xuzhou (No.KC16SL106).