Architect and academic Çiğdem Kitiş, who had vocal cord paralysis after a thyroid surgery two years ago, underwent the first ‘bilateral nerve transplant’ in Turkey. Kitiş, who was told by every doctor she went to, “There is nothing to do anymore, you have to lose your voice to restore your breath,” has regained her breath with this surgery and will regain her voice, which she said she had forgotten. Stating that this operation was the first in Turkey and the sixth in the world, Assoc. Prof. Dr. Necati Enver said that he first observed the method abroad 10 years ago and that his biggest dream since then was to perform this operation in Turkey.
Academician and architect Çiğdem Kitiş (53) lost her voice after undergoing thyroid surgery 2 years ago. She had to be hospitalized once a week because she had difficulty even breathing. Every doctor she went to told her that they could relieve her breathing by removing part of her vocal cord with a laser, but that she would lose her voice completely. Kitiş, who quit academics, broke away from the sports he loved so much and started to have difficulty even doing housework, visited dozens of doctors and received the same answer from all of them. One doctor referred him to Assoc. Prof. Dr. Necati Enver from Marmara University Pendik Training and Research Hospital Ear Nose and Throat Clinic and Kitiş learned that the method that would cure him was here.
HE WAS THE FIRST PATIENT IN TURKEY AND REGAINED HIS HEALTH
A few weeks ago, Kitiş regained her health after a difficult 10-hour surgery and became the first patient in Turkey to undergo such an operation. Kitiş, who regained her breath, dreams of singing loudly with her voice, which is expected to fully recover in about 6 months.
FIRST CENTER IN TURKEY, 4TH IN EUROPE
Performing the surgery, Assoc. Prof. Dr. Necati Enver from Marmara University Pendik Training and Research Hospital Ear Nose and Throat Clinic explained the process as follows, noting that he watched this method for the first time abroad and that his biggest dream since then was to perform this operation in Turkey: “Ms. Çiğdem came to us about 3-4 months ago with the complaint of shortness of breath. 2 years ago, she underwent surgery for nodules in the goiter gland. Unfortunately, she developed bilateral vocal cord paralysis after the surgery. Unlike unilateral vocal cord paralysis, bilateral vocal cord paralysis does not only cause hoarseness. It also causes shortness of breath. Shortness of breath makes life very difficult for patients. Ms. Çiğdem is an academician and architect. She cannot even go for a walk, and recently she could not even load the dishwasher due to shortness of breath. Normally, the current treatment for this condition is to remove part of the vocal cord with a laser. This really relieves breathing, but the patient loses his voice. In search of a treatment for this condition, bilateral vocal cord nerve transplantation is on the agenda. This surgery has been performed in 5 countries in the world so far. We are the 6th country and the 4th in Europe. It was also performed for the first time in Turkey.”
10 HOURS OF MAJOR SURGERY
Stating that the main purpose of the surgery is to restore mobility to the vocal cord, Assoc. Prof. Dr. Enver said, “In this way, both voice and breath are restored without any loss. We use the muscles of the non-functioning vocal cord to move it again using the working muscles and nerves in our neck. While doing this, we transplant the nerves of our diaphragm muscle that we use while breathing and the small muscles in our neck that are involved in swallowing. It is a very complicated operation that takes 8-10 hours and three to four teams work together. Breathing improves immediately in patients. It takes 6 months for the voice to recover and the improvement in breathing to become permanent. The fact that the vocal cord nerve is slowly recovering is that the nerve transplant we do is slowly reaching the tissue,” he said.
SOME PEOPLE HAVE TO LIVE WITH A PERMANENT HOLE IN THEIR THROAT
Explaining that vocal cord paralysis occurs when the vocal cord nerves are damaged, Assoc. Prof. Dr. Enver said, “Our vocal cord starts from our head, travels along our carotid artery, goes out in front of the lung, towards the goiter (thyroid) gland and reaches the vocal cord. This is a long way. Any surgery along the way or sometimes upper respiratory tract infections (such as Covid) can cause vocal cord paralysis. Cervical hernia, goiter surgeries, lung surgeries, lung cancer and tumors of the carotid artery of the neck can themselves cause vocal cord paralysis. The only cause of bilateral vocal cord paralysis is almost exclusively goiter surgery. Both breathing and voice are affected. In some patients, shortness of breath can lead to the opening of a permanent hole (tracheotomy). Thyroid surgeries are very common and unfortunately, some of these surgeries can cause bilateral vocal cord paralysis. Until today, there was no surgery that preserved both the patient’s voice and breath and brought them back. We have achieved this for the first time in Turkey.”
BEWARE IF YOU HAVE SHORTNESS OF BREATH AFTER GOITER SURGERY!
Assoc. Prof. Dr. Enver concluded his words by making important warnings especially for patients who have undergone goiter surgery: “In bilateral vocal cord paralysis, the voice sometimes recovers on its own and patients think they are cured. Physicians may also think that the patient has recovered. In fact, shortness of breath continues, albeit mildly, but the patient thinks that nothing will happen because his voice is good. As the years pass, as the lung weakens due to age-related lung weakening due to smoking or when an upper respiratory tract infection is experienced on top of it, patients can come to the brink of death. With suffocation-like shortness of breath. At that stage, emergency surgeries may be required, sometimes it is necessary to open a tracheotomy. Although it seems to happen to few people, many people actually face this risk. They are not aware that it is happening to them. If shortness of breath develops after goiter surgery, our patients should definitely consult an ear, nose and throat physician working in this field.”
“I FORGOT MY OWN VOICE”
Çiğdem Kitiş emphasized that she had forgotten her own voice for 2 years and now wanted to sing out loud and said the following: “I was a lecturer at a private university. 2 years ago I had thyroid surgery. 7 months later my breathing suddenly stopped. I didn’t have a voice before, I had a lot of difficulty even in the slightest bending and getting up. I had to go to the emergency room once a week. I went around a lot of doctors, but they all said that the vocal cords had turned into permanent paralysis, that they were closed, and that there would be no going back from now on. I would either have to give up my voice or my breath. They said there was no other treatment. They said that my voice would be completely gone with laser surgery. I recovered with this surgery. Even breathing is really good for me now. I never hear my voice properly, it sounds strange, I forgot my own voice. But I will remember it again. I want to sing out loud.”