Functional Results of Surgical Treatment of Bilateral Lesions of the Recurrent Laryngeal Nerve

双侧喉返神经损伤手术治疗的功能结果

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Abstract

BACKGROUND: Bilateral lesions of the recurrent laryngeal nerve require urgent deobstruction in acute conditions, and in chronic conditions, one of the surgical interventions is to widen the glottic space. OBJECTIVE: To indicate the short- and long-term functional effects of surgical deobstruction of the glottic space in bilateral lesions of the recurrent laryngeal nerve. METHODS: This study is a retrospective analysis of the treatment outcomes of 46 patients with bilateral lesions of recurrent laryngeal nerves, who were monitored using values of pulmonary function tests and visual analog scale scores of breathing preoperatively and one and six months postoperatively. RESULTS: Airflow parameters after endo-extralaryngeal laterofixation showed statistically significant improvement after one month of intervention in forced expiratory volume in one second (FEV1) (p = 0.0252), while forced vital capacity (FVC%) (p = 0.0835), peak expiratory flow (PEF%) (p = 0.0605), and peak inspiratory flow (PIF) (p = 0.0626) showed the limit of significance. The significance of values was lost after six months. Airflow parameters after posteromedial arytenoidectomy with transmuscular posterior cordectomy, mucosal preservation, and laterofixation (PMATMPCMPL) showed a statistically significant improvement in PEF (p = 0.0249) and PIF (p = 0.0476) one month after surgery. At six months, a statistically significant difference was observed in FEV1 (p = 0.0134), PEF (p = 0.0182), and PIF (p = 0.0173). CONCLUSION: Airflow parameters after endo-extralaryngeal laterofixation are better one month after surgery, while the results of PMATMPCMPL are better six months after surgery.

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