Our Summary

This research paper discusses a study on unilateral vocal fold paralysis (UVFP), a common side effect of cardiothoracic surgeries, which can affect the patient’s ability to speak and/or swallow. The study aimed to identify which cardiothoracic procedures are most often associated with UVFP, review the timing and nature of diagnosis and treatment, and report on the spontaneous recovery rate of vocal cord mobility.

The study looked at 141 patients who had undergone cardiothoracic surgery between 2002 and 2015 and later developed UVFP. The data showed that lung-related procedures were most likely to result in UVFP, with the majority of cases affecting the left side.

The study found that UVFP was being diagnosed earlier over time, but the recovery rate for vocal cord mobility was lower than other studies suggested it would be. Most patients initially received a treatment called injection laryngoplasty, with a smaller percentage eventually undergoing a procedure known as type 1 thyroplasty.

The researchers concluded that many cardiothoracic procedures can result in UVFP, particularly on the left side. The recovery rate for vocal cord mobility was lower than expected, indicating the importance of early diagnosis and potential surgical intervention.

FAQs

  1. What is Unilateral Vocal Fold Paralysis (UVFP) and how is it related to cardiothoracic surgeries?
  2. What treatments are commonly used for UVFP and how effective are they?
  3. Which cardiothoracic procedures are most likely to result in UVFP and what is the recovery rate for vocal cord mobility?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vocal cord surgery is to follow all post-operative care instructions carefully, including voice rest and vocal exercises recommended by a speech therapist. It is important to allow the vocal cords time to heal properly to ensure the best possible outcome from the surgery. Additionally, attending follow-up appointments with your healthcare provider is crucial for monitoring your progress and addressing any concerns or complications that may arise.

Suitable For

Overall, patients who are typically recommended vocal cord surgery are those who have developed unilateral vocal fold paralysis as a result of cardiothoracic surgeries, such as lung-related procedures. Patients may experience difficulties with speaking and/or swallowing due to the paralysis, and surgical intervention may be necessary to improve vocal cord mobility and function. Early diagnosis and timely treatment are crucial in improving outcomes for these patients.

Timeline

Before vocal cord surgery, a patient may experience symptoms such as hoarseness, difficulty speaking or swallowing, shortness of breath, and a weak or breathy voice. They may undergo diagnostic tests such as laryngoscopy to determine the cause of their symptoms. Once diagnosed with UVFP, the patient may undergo voice therapy or other conservative treatments before considering surgery.

After vocal cord surgery, the patient will likely experience some discomfort and hoarseness as they recover. They may need to follow specific post-operative care instructions, such as resting their voice and avoiding strenuous activities. Over time, the patient may notice improvements in their voice quality and swallowing function as the vocal cords heal and regain mobility. Follow-up appointments with the surgeon and speech therapist may be necessary to monitor progress and make any necessary adjustments to treatment plans.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vocal cord surgery may include:

  1. What specific procedure will be performed on my vocal cords?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery time expected to be?
  4. What kind of post-operative care will be required?
  5. Are there any alternative treatment options available?
  6. What is the success rate of this surgery for patients with my condition?
  7. Will I need speech therapy or rehabilitation after the surgery?
  8. How soon after the surgery will I be able to speak and swallow normally again?
  9. Will I need any additional follow-up appointments or treatments after the surgery?
  10. What can I do to optimize my chances of a successful outcome from the surgery?

Reference

Authors: Puccinelli C, Modzeski MC, Orbelo D, Ekbom DC. Journal: Am J Otolaryngol. 2018 Mar-Apr;39(2):175-179. doi: 10.1016/j.amjoto.2017.11.011. Epub 2017 Dec 6. PMID: 29254704