Clinical research of unilateral posterior glottic cleft dilatation in the treatment of bilateral vocal cord paralysis dyspnea

Abstract

Objective:The aim of this study is to evaluate the efficacy of unilateral posterior glottic cleft dilatation with low-temperature plasma under the endoscope in the treatment of bilateral vocal cord paralysis dyspnea. Methods:Forty-one patients with bilateral vocal cord paralysis were recruited, and they were all admitted to the Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhengzhou University from March 2014 to June 2019. Those 41 patients were all treated with low-temperature plasma to completely resect unilateral arytenoid cartilage and the posterior 1/3 of the ipsilateral vocal cord. Fiber laryngoscopy was performed before and after operation. The clinical efficacy of the operation was evaluated by the size of glottis cleta, the improvement rate of dyspnea, voice satisfaction, swallowing function, the tracheal cannula removal rate and postoperative complication rate. Results:Forty-one patients were followed up for 24-88 months. The rate of one-pass extubation was 88.57%（31/35）. The satisfaction rate of voice was 92.11%（35/38）. The recovery rate of swallowing function was 97.56%（40/41）. Conclusion:This study demonstrated that the application of low-temperature plasma in unilateral posterior glottic cleft dilatation could significantly improved the ventilation function of patients with bilateral vocal cord paralysis, with a reliable curative effect and a high extubation rate. It is a safe, reliable, simple and minimally invasive treatment option for the treatment of bilateral vocal cord paralysis.