Bilateral vocal fold immobility: a 13 year review of etiologies, management and the utility of the empey index
Tóm tắt
Bilateral vocal fold immobility (BVFI) is a rare diagnosis causing dyspnea, dysphonia and dysphagia. Management depends on respiratory performance, airway patency, vocal ability, and quality-of-life priorities. The authors review the presentation, management and outcome in patients diagnosed with BVFI. The utility and efficacy of the Empey index (EI) and the Expiratory Disproportion Index (EDI) are evaluated as an objective monitoring tools for BVFI patients. A 13-year retrospective review was performed of BVFI patients at St. Michael’s Hospital, University of Toronto, a tertiary referral centre for laryngology. Forty-eight patients were included; 46 presented with airway obstruction symptoms. Tracheotomy was required for airway management in 40 % of patients throughout the course of their treatment, which was reduced to 19 % at the end of the study period. Twenty-one patients underwent endoscopic arytenoidectomy/cordotomy. Non-operative management included continuous positive airway pressure devices. Pulmonary function testing was carried out in 29 patients. Only a portion of the BVFI patients met the defined upper airway obstruction criteria (45 % EI and 52 % EDI). Seven patients had complete pre- and post-operative PFTs for comparison and all seven had ratios that significantly improved post-operatively which correlated clinically. The EI and EDI have limited use in evaluating patients with who have variable upper airway obstruction, but may be helpful in monitoring within subject airway function changes.
Tài liệu tham khảo
Olthoff A, Zeiss D, Laskawi R, Kruse E, Steiner W. Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis. Ann Otol Rhinol Laryngol. 2005;114:599–604.
Ozdemir S, Tuncer U, Tarkan O, Kara K, Surmelioglu O. Carbon dioxide laser endoscopic posterior cordotomy technique for bilateral abductor vocal cord paralysis: a 15-year experience. JAMA Otolaryngol Head Neck Surg. 2013;139:401–4.
Segas J, Stavroulakis P, Manolopoulos L, Yiotakis J, Adamopoulos G. Management of bilateral vocal fold paralysis: experience at the University of Athens. Otolaryngol Head Neck Surg. 2001;124:68–71.
Empey DW. Assessment of upper airways obstruction. Br Med J. 1972;3:503–5.
France JE, Thomas MJ. Clinical use of the empey index in the emergency department. Emerg Med J. 2004;21:642–3.
Nouraei SAR, Nouraei SM, Patel A, Murphy K, Giussani DA, Koury EF, et al. Diagnosis of laryngotracheal stenosis from routine pulmonary physiology using the expiratory disproportion index. Laryngoscope. 2013;123:3099–104.
Tucker HM. Laryngeal paralysis: aetiology and management. Otolaryngology. Philadelphia: Harper and Raw Publishers; 1980. p. 1–11.
Cheung EJ, McGinn JD. The surgical treatment of bilateral vocal fold impairment. Operative Techniques in Otolaryngology-Head and Neck Surgery. 2007;18:144–55.
Dursen G, Gokcan K. Aerodynamic, acoustic and functional results of posterior transverse laser cordotomy for bilateral abductor vocal cord paralysis. J Laryngol Otol. 2006;120:282–8.
Jackson C. Ventriculocordectomy: a new operation for the cure of goitrous glottic stenosis. Arch Surg. 1922;4:257–74.
Hoover W. Bilateral abductor paralysis: operative treatment of submucous resection of the vocal cord. Arch Otolaryngol. 1932;15:337–55.
King B. A new and function restoring operation for bilateral abductor cord paralysis. JAMA. 1939;112:814–23.
Kelly J. Surgical treatment of bilateral paralysis of the abductor muscles. Arch Otolaryngol. 1941;33:293–304.
Woodman D. A modification of the extralaryngeal approach to arytenoidectomy for bilateral abductor paralysis. Arch Otolaryngol. 1946;43:63–5.
Thornell W. Intralaryngeal approach for arytenoidectomy in bilateral abductor paralysis of the vocal cords. Arch Otolaryngol. 1948;47:505–8.
Manolopoulos L, Stavroulaki P, Yiotakis J, Segas J, Adamopoulos G. CO2 and KTP-532 laser cordectomy for bilateral vocal fold paralysis. J Laryngol Otol. 1999;113:637–41.
Ossoff R, Sisson GA, Duncavage JA, Moselle H, Andrews PE, McMillan WG. Endoscopic laser arytenoidectomy for the treatment of bilateral vocal cord paralysis. Laryngoscope. 1984;94:1293–7.
Ossoff RH, Duncavage JA, Krespi YP, Shapshay SM, Sisson Sr GA. Endoscopic laser arytenoidectomy revisited. Ann Otol Rhinol Laryngol. 1990;99:764–71.
Dennis D, Kashima H. Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol. 1989;98:930–4.
Khalifa MC. Head neck surg. simultaneous bilateral posterior cordectomy in bilateral vocal fold paralysis. Otolaryngol Head Neck Surg. 2005;132(2):249–50.
Moustafa H, ElGuindy A, ElSherief S, Targam A. The role of endoscopic laterofixation of the vocal cord in the treatment of bilateral abductor paralysis. J Laryngol Otol. 1992;106(1):31–4.
Katilmiş H, Oztürkcan S, Başoğlu S, Aslan H, Ilknur AE, Erdoğan NK, et al. New technique for the treatment of bilateral vocal cord paralysis: vocal and ventricular fold lateralization using crossing sutures with thyroplasty technique. Acta Otolaryngol. 2011;131(3):303–9.
Hyodo M, Nishikubo K, Motoyoshi K. Laterofixation of the vocal fold using an endo-extralaryngeal needle carrier for bilateral vocal fold paralysis. Auris Nasus Larynx. 2009;36(2):181–6.
Benninger MS, Hseu A. Laser surgical management of bilateral vocal fold immobility. Operative Techniques in Otolaryngology-Head and Neck Surgery. 2011;22:116–21.
Rosenthal-Swibel L, Benninger MS, Deeb RH. Vocal fold immobility: a longitudinal analysis of etiology over 30 years. Laryngoscope. 2007;117:1864–70.
Wiest GH1, Ficker JH, Lehnert G, Hahn EG. Secondary obstructive sleep apnea syndrome in a patient with tracheal stenosis and bilateral recurrent paresis. Successful treatment with nasal continuous positive airway pressure therapy. Dtsch Med Wochenschr. 1998;123(17):522–6.
Wolter NE and Anderson J. Polysomnography: Assessment of decannulation readiness in chronic upper airway obstruction. Laryngoscope 2014;124(11):2574-8. doi:10.1002/lary.24836
Woodson G. Upper airway anatomy and function. In: Johnson J, Rosen C, Bailey B, editors. Bailey’s head and neck surgery – otolaryngology. 5th ed. Philadelphia, Pa: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014. p. 865–77.
Marina MB1, Marie JP, Birchall MA. Laryngeal reinnervation for bilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg. 2011;19(6):434–8.