Laser ventriculocordectomy for treatment of bilateral vocal cord paralysis by 810 nm diode laser

This is a prospective two years study between October 2004 and October 2006, designed to verify the use and effectiveness of 810 nanometer diode laser as alternative to CO[2] laser in the management of patients with bilateral vocal cords paralysis in adductor position due to different causes and of different duration causing airway embarrassment. This study included eight patients consisted of five females and three males aged between 35 and 53 years. Six patients "were tracheostomized due to stridor. The other two patients had dyspnea and mild stridor on exertion but wasn't tracheostomized. Laser ventriculocordectomy done under general anaesthesia by direct laryngoscopy and microscope by using 810nm diode laser 15 was used for management of these cases. The power of laser used was 5 watt for resection of posterior part of the vocal cord increasing up to 10 watt for resection of vocal process of arytenoid and posterior false fold by using continuous mode. All patients were improved by surgery, although one patient required another session for improvement of his airway. The tracheostomized patients were decanulated successfully after different duration and the other two patients with dyspnea and stridor got improved respiratory function significantly after surgery, and mostly fair to good voice quality, none of them developed severe aspiration. Laser ventriculocordectomy using diode laser is an effective method for treatment of bilateral vocal cord paralysis in adduction position as an alternative to CO[2] laser, because it is easy technique, more precise and of high success rate even if the patient need more than one session

xylocaine test as a prognostic aid for surgery in Sluder's neuralgia

Patients with facial pain without any overt disease especially of the nose and paranasal sinuses are often diagnosed as having Sluder's neuralgia. Large middle turbinates or septal deflections compressing the ethmoidal nerves have been regarded as one of the causes of this pain in those who have their sinus computed tomography [CT] clear. To evaluate the xylocaine test as a prognostic aid for surgical treatment for Sluder's neuralgia. Sixty-one cases were seen; all of them had the xylocaine test positive. They were treated surgically by endoscopic middle turbinectomy or septal surgery. All had relief from the symptoms 4 months postoperatively, except in five cases relief was achieved after revision surgeries for intranasal synechiae. The xylocaine [10 per cent] test seemed to be a good prognostic aid for the surgical procedures for those with Sluder's neuralgia when medical treatment did not seem to relieve the symptom