Experiencia clínica en el manejo de parálisis cordales en posición abierta: tratamiento actual / Clinical experience in the management of vocal cords paralysis in abduction position: actual treatment

ABSTRACT

Introduction: The larynx is nerved by the recurrent and superior laryngeal nerves, translating its damage in pareses or paralysis of vocal cords, causing hoarseness in most of patients, and occasionally dispnea and deglutory alterations. The management of vocal cords paralysis in abduction position has been controversial. It seems that phoniatric treatment would seem to be a reasonable and effective alternative because the compensation capacity. Surgical manage, in other hand, has offered demonstrated effectiveness in the paralyses that don’t respond to phoniatric treatment, emphasizing techniques of medialization thiroplasty. Objectives: To reflect our epidemiology, phoniatric manage and experience as surgical team in medialization hiroplasty and to evaluate the results. Materials and Methods: retrospective study of patients with vocal cord paralysis in abduction position evaluated in Voice Unit of Clinic Hospital of University of Chile. Complete otolaryngological evaluation plus laryngeal electromyography were performed. Two groups were analyzed according manage received, describing clinicallythe degree of hoarseness at the beginning and the end of treatment. Results: 61 percent of the nonsurgical manage paralysis causes were secondary to surgery, mainly on the thyroid gland (81 percent). In these a significant improvement of the hoarseness with the phoniatric manage exists. In the group subject medialization thiroplasty 55 percent were secondary to surgery with a 77 percent of postoperating satisfactory evaluation.