Ранняя реабилитация дыхательной функции у пациентов, имеющих двусторонний парез голосовых складок

Abstract

Therapeutic treatment of airway stenosis caused by vocal cord paralysis is a major challenge. Methodology, organization of research, treatment, and observation of such patients are necessary since the risk of developing respiratory failure and imposing a tracheotomy in the first months of the disease is especially high. Early diagnosis of impaired vocal fold mobility, the appointment of treatment, will contribute to the speedy rehabilitation of the respiratory function and reduce the number of complications. The purpose of the study is to develop a tactic for treatment and examination in patients with bilateral vocal fold paresis. The object of the study were 14 female patients with a diagnosis of bilateral vocal fold paresis caused by thyroid surgery. The following spirometry indicators were evaluated: FVC, FEV1, FEV/FVC, PEF, MEF75, MEF50, MEF25, which showed a significant impairment of air permeability at the level of the vocal folds, impaired ventilation of the bronchial tree, and a decrease in lung capacity. Endoscopic examination of the larynx also revealed a violation of the mobility of the vocal folds, which were in the paramedial position in 6 patients and in the median position in 6. The physical component of health and the psychological component were also assessed according to the standardized international questionnaire SF-36. The results obtained indicated an extreme degree of decrease in the patient’s psychological state on the verge of depression and also indicated the presence of respiratory failure. The information obtained as a result of such an examination can help in the choice of treatment tactics and further rehabilitation of patients.