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Coblator Arytenoidectomy in the Treatment of Bilateral Vocal Cord Paralysis.

Googe B, Nida A, Schweinfurth J - Case Rep Otolaryngol (2015)

Bottom Line: In the coming months the patient's tracheostomy tube was gradually downsized and eventually capped.She was decannulated eight months after surgery, speaking well and without complaints.Details of the surgical procedure and outcome will be discussed.

View Article: PubMed Central - PubMed

Affiliation: University of Mississippi School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA.

ABSTRACT
A 77-year-old female with bilateral vocal cord paralysis and dependent tracheostomy status after total thyroidectomy presented to clinic for evaluation of decannulation via arytenoidectomy. Preliminary data suggests coblation versus standard CO2 laser ablation in arytenoidectomy may provide benefits in terms of decreased tissue necrosis and patient outcome. The patient elected to proceed with arytenoidectomy by coblation. The initial procedure went well but postoperative bleeding required a return trip to the operating room for hemostasis. In the coming months the patient's tracheostomy tube was gradually downsized and eventually capped. She was decannulated eight months after surgery, speaking well and without complaints. Details of the surgical procedure and outcome will be discussed.

No MeSH data available.


Related in: MedlinePlus

Final view of the larynx following completion of left medial arytenoidectomy.
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fig3: Final view of the larynx following completion of left medial arytenoidectomy.

Mentions: The patient was taken to the operating room (OR), sedated with general anesthesia, and ventilated via her tracheostomy tube. A supraglottic laryngoscope was then inserted and 2 mL of 4% lidocaine was sprayed onto the glottis for topical anesthesia. The oral cavity, oropharynx, hypopharynx, and larynx were found to be normal with medialization of vocal folds bilaterally (Figure 1). Both cricoarytenoid joints moved normally on palpation. Afrin pledgets were applied to the left arytenoid. An ArthroCare ENT Coblator was utilized to resect soft tissue and cartilage of the left arytenoid beginning at the vocal process. The larynx was initially quite sensitive to the coblate function causing frequent spasms of the laryngeal musculature (Figure 2). As dissection proceeded deeper contraction seemed to subside but brisk bleeding was encountered. Hemostasis was attained using the coagulation function of the coblator. A sufficient amount of cartilage was removed to achieve adequate expansion of the airway (Figure 3). The patient was awakened from general anesthesia and transferred to the postanesthesia care unit in stable condition.


Coblator Arytenoidectomy in the Treatment of Bilateral Vocal Cord Paralysis.

Googe B, Nida A, Schweinfurth J - Case Rep Otolaryngol (2015)

Final view of the larynx following completion of left medial arytenoidectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4589618&req=5

fig3: Final view of the larynx following completion of left medial arytenoidectomy.
Mentions: The patient was taken to the operating room (OR), sedated with general anesthesia, and ventilated via her tracheostomy tube. A supraglottic laryngoscope was then inserted and 2 mL of 4% lidocaine was sprayed onto the glottis for topical anesthesia. The oral cavity, oropharynx, hypopharynx, and larynx were found to be normal with medialization of vocal folds bilaterally (Figure 1). Both cricoarytenoid joints moved normally on palpation. Afrin pledgets were applied to the left arytenoid. An ArthroCare ENT Coblator was utilized to resect soft tissue and cartilage of the left arytenoid beginning at the vocal process. The larynx was initially quite sensitive to the coblate function causing frequent spasms of the laryngeal musculature (Figure 2). As dissection proceeded deeper contraction seemed to subside but brisk bleeding was encountered. Hemostasis was attained using the coagulation function of the coblator. A sufficient amount of cartilage was removed to achieve adequate expansion of the airway (Figure 3). The patient was awakened from general anesthesia and transferred to the postanesthesia care unit in stable condition.

Bottom Line: In the coming months the patient's tracheostomy tube was gradually downsized and eventually capped.She was decannulated eight months after surgery, speaking well and without complaints.Details of the surgical procedure and outcome will be discussed.

View Article: PubMed Central - PubMed

Affiliation: University of Mississippi School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA.

ABSTRACT
A 77-year-old female with bilateral vocal cord paralysis and dependent tracheostomy status after total thyroidectomy presented to clinic for evaluation of decannulation via arytenoidectomy. Preliminary data suggests coblation versus standard CO2 laser ablation in arytenoidectomy may provide benefits in terms of decreased tissue necrosis and patient outcome. The patient elected to proceed with arytenoidectomy by coblation. The initial procedure went well but postoperative bleeding required a return trip to the operating room for hemostasis. In the coming months the patient's tracheostomy tube was gradually downsized and eventually capped. She was decannulated eight months after surgery, speaking well and without complaints. Details of the surgical procedure and outcome will be discussed.

No MeSH data available.


Related in: MedlinePlus