eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
Current issue Archive Videoforum Manuscripts accepted About the journal Supplements Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank


3/2018
vol. 13
 
Share:
Share:
more
 
 
ENT
abstract:
Original paper

Minimally invasive injection laryngoplasty in the management of unilateral vocal cord paralysis after video-assisted mediastinal lymph adenectomy

H. Volkan Kara, Aysegul Batioglu Karaaltin, Ezel Ersen, Elvin Alaskarov, Burcu Kilic, Akif Turna

Videosurgery Miniinv 2018; 13 (3): 388–393
Online publish date: 2018/05/22
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Video-assisted mediastinal lymphadenectomy (VAMLA) is a valuable tool for invasive staging of the mediastinum. Unilateral vocal cord paralysis (UVCP) may occur in patients following VAMLA and may result in secretion retention within the lungs, atelectasis and associated infectious situations such as pneumonia. Minimally invasive injection laryngoplasty (ILP) is the treatment of choice in UVCP.

Aim
To evaluate the efficacy and success of acute minimally invasive injection laryngoplasty for patients with UVCP following VAMLA.

Material and methods
Patients with the symptom of dysphonia following VAMLA were reviewed. All of the patients had UVCP according to the video laryngoscopy examination and had symptoms of aspiration and ineffective coughing. The Voice Handicap Index (VHI) questionnaire and maximum phonation time (MPT) were measured. Minimally invasive ILP was performed under general anesthesia with 1 cm of hyaluronic acid.

Results
There were 525 consecutive non-small cell lung cancer (NSCLC) patients who underwent VAMLA. Five (0.95%) of the patients had UVCP and were suffering from aspiration during oral intake and ineffective coughing reflex. Maximum phonation time (MFT) was measured before and after ILP, and the results were 7.1 ±1.6 and 11.1 ±2.3 s, respectively (p < 001). The Voice Handicap Index-10 (VHI-10) score was 30.4 ±4.7 and 13.4 ±3.5 (p < 0.01), respectively. Patients underwent surgical lung resection. There was no morbidity or mortality.

Conclusions
Unilateral vocal cord paralysis may occur as a complication of VAMLA. ILP may be an active tool for treating UVCP before anatomical lung resection to avoid potential morbidities. Successful management of this complication with multidisciplinary team work may encourage the use of VAMLA more frequently.

keywords:

minimally invasive injection laryngoplasty, unilateral vocal cord paralysis, video-assisted mediastinal lymph adenectomy

references:
Call S, Obiols C, Rami-Porta R, et al. Video-assisted mediastinoscopic lymphadenectomy for staging non-small cell lung cancer. Ann Thorac Surg 2016; 101: 1326-33.
Silvestri GA, Gonzalez AV, Jantz MA, et al. Methods for staging non-small cell lung cancer: diagnosis and management of lung cancer. 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143: 211-50.
Leyn PD, Dooms C, Kuzdzal J, et al. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg 2014; 45: 787-98.
Turna A, Demirkaya A, Ozkul S, et al. Video-assisted mediastinoscopic lymphadenectomy is associated with better survival than mediastinoscopy in patients with resected non-small cell lung cancer. J Thorac Cardiovasc Surg 2013; 146: 774-80.
Yasufuku K, Pierre A, Darling G, et al. A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer. J Thorac Cardiovasc Surg 2011; 142: 1393-400.
Heurtgen M, Friedel G, Toomes H, Fritz P. Radical video-assisted mediastinoscopic lymphadenectomy (VAMLA): technique and first results. Eur J Cardiothorac Surg 2002; 21: 348-51.
Graboyes EM, Bradley JP, Meyers BF, et al. Efficacy and safety of acute injection laryngoplasty for vocal cord paralysis following thoracic surgery. Laryngoscope 2011; 121: 2406-10.
Fang TJ, Hsin LJ, Chung HF, et al. Office-based intracordal hyaluronate injections improve quality of life in thoracic-surgery-related unilateral vocal fold paralysis. Medicine (Baltimore) 2015; 94: e1787.
Gockel I, Kneist W, Keilmann A, et al. Recurrent laryngeal nerve paralysis (RLNP) following esophagectomy for carcinoma. Eur J Surg Oncol 2005; 31: 277-81.
Hulscher JB, van Sandick JW, Devriese PP, et al. Vocal cord paralysis after subtotal oesophagectomy. Br J Surg 1999; 86: 1583-7.
Baba M, Natsugoe S, Shimada M, et al. Does hoarseness of voice from recurrent nerve paralysis after esophagectomy for carcinoma influence patient quality of life? J Am Coll Surg 1999; 188: 231-6.
Deary IJ, Webb A, Mackenzie K, et al. Short, self-report voice symptom scales: psychometric characteristics of the voice handicap index-10 and the vocal performance questionnaire. Otolaryngol Head Neck Surg 2004; 131: 232-5.
Rosen CA, Lee AS, Osborne J, et al. Development and validation of the voice handicap index-10. Laryngoscope 2004; 114: 1549-56.
Young VN, Jeong K, Rothenberger SD, et al. Minimal clinically important difference of voice handicap index-10 in vocal fold paralysis. Laryngoscope 2017; 8 doi: 10.1002/lary.27001. Epub ahead of print.
Maslan J, Leng X, Rees C, et al. Maximum phonation time in healthy older adults. J Voice 2011; 25: 709-13.
Arnold GE. Vocal rehabilitation of paralytic dysphonia: II. Acoustic analysis of vocal function. Arch Otolaryngol 1955; 62: 593-601.
Speyer R. Effects of voice therapy: a systematic review. J Voice 2008; 22: 565-80.
Caton T, Thibeault SL, Klemuk S, et al. Viscoelasticity of hyaluronan and nonhyaluronan based vocal fold injectables: implications for mucosal versus muscle use. Laryngoscope 2007; 117: 516-21.
Yung KC, Likhterov I, Courey MS. Effect of temporary vocal fold injection medialization on the rate of permanent medialization laryngoplasty in unilateral vocal fold paralysis patients. Laryngoscope 2011; 121: 2191-4.
Sielska-Badurek EM, Sobol M, Jędra K, et al. Injection laryngoplasty as miniinvasive office-based surgery in patients with unilateral vocal foldparalysis – voice quality outcomes. Videosurgery Miniinv 2017; 12: 277-84.
  
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe