A comparative study of laser posterior cordotomy and combined laser posterior cordotomy with suture lateralization in bilateral vocal cords abductor paralysis.

BACKGROUND: A prospective randomized study was conducted on 40 patients with true bilateral vocal fold abductor paralysis. The patients under the study were divided into 2 groups, group (A) including 20 patients who underwent laser posterior cordotomy and another group (B) including 20 patients who underwent combined laser posterior cordotomy with suture lateralization, the patients under the study presented at otorhinolaryngology outpatient clinic at faculty of medicine, Cairo University. The study was conducted in the period from January 2018 till January 2021. RESULTS: No significant difference between both surgeries regarding respiratory efficiency, voice handicap index (VHI) scores, and presence of postoperative aspiration. A significant difference was found regarding some Computerized Speech Lab (CSL) measures (there is a statistically significant difference between the 2 groups in favor of group (b) regarding N to H ratio in week 2 postoperatively and maximum phonation time in 4-week postoperatively) and granuloma formation (granuloma formation was more common in the group (A) than group (B)). CONCLUSION: Combined laser posterior cordotomy with suture lateralization in bilateral vocal folds abductor paralysis showed fewer complications and better maximum phonation time and a comparable effect to laser cordotomy regarding respiration.

Cervical osteophytosis and spine posture: contribution to swallow disorders and symptoms.

PURPOSE OF REVIEW: The article reviews the effects of cervical osteophytosis and spine posture on swallowing, and how they can cause dysphagia. RECENT FINDINGS: Cerivical osteophytosis which is a bony overgrowth of the cervical spines, it affects the swallowing through different mechanisms, including direct mechanical compression of the pharynx and esophagus, disturbances of normal epiglottic tilt over the inlet of the larynx by the osteophytes at C3-C4 level, inflammatory reactions in the tissues around the esophagus and cricopharyngeal spasm. Also, cervical spine posture in normal individuals could affect the swallowing mechanism by disturbance of the sphincteric action of the larynx and upper esophageal sphincter. SUMMARY: Cervical osteophytosis and abnormal cervical curvature may be overlooked by the Otolaryngologists as causes of swallowing disorders. The diagnosis is usually confirmed by radiologic study for the cervical spine. Cervical abnormality should be kept in mind while we are investigating patients with swallowing problem, and postural modification may help in treatment of such cases.

Transoral endoscopic adenoidectomy.

Objective. Adenoid curette guided by an indirect transoral mirror and a headlight is a simple and quick procedure that has already been in use for a long time, but this method carries a high risk of recurrence unless done by a well-experienced surgeon. The purpose of this paper was to evaluate the efficacy of transoral endoscopic adenoidectomy in relieving the obstructive nasal symptoms. Methods. 300 children underwent transoral endoscopic adenoidectomy using the classic adenoid curette and St Claire Thomson forceps with a 70( composite function) Hopkins 4-mm nasal endoscope introduced through the mouth and the view was projected on a monitor. Telephone questionnaire was used to follow-up the children for one year. Flexible nasopharyngoscopy was carried out for children with recurrent obstructive nasal symptoms to detect adenoid rehypertrophy. Results. No cases presented with postoperative complications. Only one case developed recurrent obstructive nasal symptoms due to adenoid regrowth and investigations showed that he had nasal allergy which may be the cause of recurrence. Conclusion. Transoral endoscopic adenoidectomy is the recent advancement of classic curettage adenoidectomy with direct vision of the nasopharynx that enables the surgeon to avoid injury of important structures as Eustachian tube orifices, and also it gives him the chance to completely remove the adenoidal tissues.