Acute temporary laterofixation for treatment of bilateral vocal cord paralyses after surgery for advanced thyroid carcinoma.

Abstract

Four patients with breathing obstruction after surgery for advanced thyroid carcinoma were found to have bilateral vocal cord paralysis. They were treated with acute temporary laterofixation of one of the vocal cords. This measure established a stable airway in all the patients and maintained acceptable voices. None of the patients had aspiration problems. After 4 to 7 weeks the nonlaterofixated vocal cord had regained normal function in each patient, and the thread used for the laterofixation could be removed. In the two patients who had anatomically intact recurrent laryngeal nerves bilaterally, the previously laterofixated vocal cords displayed normal movements within another 8 weeks in one patient and 7 weeks in the other patient. This observation demonstrates that a temporary laterofixation can be done without lasting damage to the vocal cord. Acute temporary vocal cord laterofixation is a procedure that has the potential to minimize the morbidity and complications of bilateral vocal cord paralysis, and in most patients it can be done instead of tracheostomy.