Current Thoracic Surgery 2021 , Vol 6 , Issue 2
Efficiency of vocal cord medialization for recurrent laryngeal nerve dysfunction following pulmonary resections
Melis E Demirağ1,Çağatay Tezel2,Volkan Baysungur2,Serdar Evman2, ,
1Department of Otorhinolaryngology, University of Health Sciences, Kartal Dr.Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
2Department of Thoracic Surgery, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
DOI : 10.26663/cts.2021.0012 Viewed : 2895 - Downloaded : 1230 Background: Evaluating the incidence of postoperative vocal cord dysfunction after pulmonary resections and the impact of timing for vocal cord medialization on preventing postoperative pulmonary complications for these patients.

Materials and Methods: Patients developing vocal cord dysfunction (VCD)/unilateral vocal cord paralysis (UVCP) after pulmonary resection were examined retrospectively, in terms of postoperative pulmonary complication (PPC) rates and hospital length of stay. Total of 2740 patients underwent anatomical pulmonary resection for malignancy. Eleven patients were referred to otolaryngology team with pre-diagnosis of VCD following the operation. UVCP diagnosis was confirmed with indirect laryngoscopic examination.

Results: UVCP diagnosis was confirmed in 8 (0.3%) with indirect laryngoscopic examination. Performed resections were left upper lobectomy in 3 and left pneumonectomy in 5 patients. Atelectasis necessitating bronchoscopy and pneumonia were the PPC, seen in 3 (37.5%) patients. Calcium hydroxyapatite injection for 6 patients and polytetrafluoroethylene graft implantation for 2 patients was performed. Mean duration between pulmonary resection and medialization was 5.3 days in patients developing PPC and 3.6 days in patients with no PPC (p = 0.011). All patients were discharged within an average of 8.1 (6-13) days, uneventfully. One patient required re-injection of calcium hydroxyapatite on 5th month. Throughout a mean follow-up duration of 14.8 months, all patients had stable vocal cord position.

Conclusions: Vocal cord medialization can be performed safely for postthoracotomy UVCP. In order to minimize phonetic and respiratory complications, this procedure must be applied on early postoperative period. Keywords : acquired vocal cord palsy, complications, medialization laryngoplasty, thoracotomy