Vocal cords paralysis
U/L vocal cord palsy treatment includes: (AIIMS Nov 2009)
|A||Isshiki type I thyroplasty|
|B||Isshiki type II thyroplasty|
Ref: Dhingra Sth/ed pg 320; s/e, p 300 Logan & Turner 7 O'h/ 782,783 Combined (Complete) Paralysis (Recurrent & Superior Laryngeal nerve paralysis): Unilateral
It leads to paralysis of all the muscles of larynx on one side except the cricoarytenold? which also receive innervations from the op¬posite side. Vocal cord of the affected side will lie in the cadavaric position", The healthy cord is unable to approximate the paralysed side. This results in hoarseness of voice and aspiration occurs through the glottis.
• Speech therapy - With proper speech therapy the healthy cord may approximate the paralysed cord.
• Procedures to medialise the cord
- Injection of Teflon paste, lateral to the paralysed cord?
- Thyroplasty type IQ
- Muscle or cartilage implant?
- Arthrodesis of cricoarytenoid joint (Also known as Reversed
Woodman's operation - Logan & Turner 10th/182)
Woodman's operatior/' (External arytenoidectomy) is done in bilateral abductor paralysis- Logan & Turner 10th/183
Endoscopic laser arytenoidectomy & Isshiki type /I thyropiasty? is done for lateralization of cord (in bilateral abductor paralysis)"-Dhingra 5 th/318,319&362