RESTORING AIRWAY WITH ACCEPATBLE VOICE IN BILATERAL VOCAL CORD PALSY
Bilateral vocal cord palsy is a difficult situation for the surgeon and the patient.
Tracheostomy is safe for the surgeon but undesirable from the patient’s point of view.
A 55 year old female presented to us with noisy breathing occuring during sleep and which increased during exertion and attacks of URI , was a case of past hemithyroidectomy 10 years back (done elsewhere) following which the complaints started.
VLS showed B/L vocal cord in paramedian position (bipahasic)
After elective tracheostomy operation done was Posterior cordotomy with submucosal partial arytenoidectomy followed by cordoplasty
Equipment used : Operating microscope, Weerda’s expanding MLS scope, 30 watt CO2 LASER with micromanipulator , Vocal cord separator, 5-0 Vicryl
The tracheostomy tube was taken out at the end of 4 days.
Postoperative voice is adequate to have conversation in the same room but not adequate to raise voice in anger !!!