Laser Bilateral Vocal Cord Paralysis Surgery

What is bilateral vocal cord paralysis?

Bilateral or bilateral vocal cord paralysis (BVCP) is a condition in which both vocal cords (or vocal cords) are paralyzed or unable to move properly. If this happens, breathing, voice and swallowing, which are the tasks of the vocal cords, can be adversely affected.

Symptoms of Bilateral Vocal Cord Paralysis

Bilateral vocal cord paralysis is a condition in which the vocal cords lose their ability to move and means that both vocal cords are paralyzed. This can lead to serious difficulties with vital functions such as breathing, voice production and swallowing. Symptoms may vary depending on the severity of the paralysis and the position of the vocal cords. Here are the symptoms and explanations that may occur due to this condition:

1. Breathing Difficulties

In bilateral vocal cord paralysis, the vocal cords may remain in the midline, that is, in a position very close to each other. This causes narrowing of the airway and can make breathing difficult, especially during physical activity. In advanced cases, the patient may experience shortness of breath even at rest. It can progress to respiratory failure as a condition requiring urgent intervention.

2. Hoarseness or Loss of Voice

When the vocal cords cannot move, their vibrations do not occur normally. As a result:

– The voice may sound hoarse, weak or breathy.

– In some cases, the voice may disappear completely.

This change in voice quality can also have a negative impact on social and professional life. Patients may find it difficult to have everyday conversations and this can make it difficult to express themselves.

3. Wheezing Breath (Stridor)

Stridor is a high-pitched whistle-like sound heard when breathing. This sound is caused by a narrowing of the airway and is usually due to the vocal cords being in a semi-closed position. Stridor can occur both during the day and at night, but can be particularly pronounced during sleep.

4. Moaning or wheezing during night sleep

In bilateral vocal cord paralysis, audible breathing during sleep is common. This can be characterized by “moaning” or “wheezing” sounds. Due to the narrow airway, these sounds are caused by vibrations during breathing and are noticed by the patient’s relatives. It can become more pronounced, especially during REM sleep.

5. Swallowing Difficulty and Aspiration Risk

The vocal cords are not only involved in voice production, but also in protecting the airway during swallowing. Paralysis of both vocal cords can increase the risk of food or liquid entering the airway. This condition

– The feeling of suffocation,

– Coughing fits when eating or drinking water,

– It can lead to recurrent attacks of pneumonia.

6. Chronic Cough and the Need to Clear Throat

Patients with bilateral vocal cord paralysis may develop a chronic cough due to an inability to clear the air effectively or manage secretions (phlegm). This causes the patient to feel the need to constantly clear their throat and can become uncomfortable over time.

General Effects of Symptoms

Bilateral vocal cord paralysis can significantly reduce patients’ quality of life. These symptoms related to breathing, swallowing and voice can make it difficult for the patient to perform daily activities and can lead to social isolation. Early diagnosis and appropriate treatment options play a critical role in improving patients’ quality of life.

If you or your loved ones have one or more of the above symptoms, it is important to consult an otolaryngologist for a comprehensive evaluation.

Treatment of bilateral vocal cord paralysis

Surgical interventions are generally preferred in patients who have breathing problems at the forefront and cannot get results with conservative methods. There are various surgical methods for bilateral vocal cord paralysis:

a. Tracheotomy

It is a life-saving intervention in emergency respiratory problems. A hole is made in the neck to open the airway and allow the patient to breathe freely. Although it is not a long-term solution, it can be used as a temporary or permanent option in severe cases. It is not our first treatment option due to the decrease in quality of life it causes in patients.

b. Endoscopic Laser Surgery (Laser bilateral vocal cord paralysis surgery)

It is the removal or reduction of part of the vocal cords with the help of a laser. It is a minimally invasive procedure with a shorter recovery time. The aim is to preserve both breathing and voice functions.

c. Bilateral Vocal Cord Nerve Transplantation (Laryngeal Reinnervation)

It aims to reconstruct damaged vocal cord nerves. In the long term, it can restore the mobility and function of the vocal cords.

The Role of Laser Surgery in Bilateral Vocal Cord Paralysis

Laser surgery is one of the most commonly used methods to treat bilateral vocal cord paralysis. This minimally invasive technique aims to increase breathing capacity by expanding the area that causes constriction in the vocal cords.

Treatment Process

Preparation: Before the procedure, the patient undergoes a detailed examination. The condition of the vocal cords is evaluated with an endoscope.
Laser Surgery: A part of the vocal cords is removed with the help of a laser by entering through the mouth. This procedure facilitates breathing by widening the narrowed airway.
Outcome: The main aim of the surgery is to increase breathing capacity. However, some loss of voice quality may occur. For this reason, the patient is informed before surgery in a way to ensure a balance between voice and breathing.

Advantages

Fast Recovery: Since laser surgery is less invasive than other open surgical methods, the recovery period is short.
Low Risk: It is safe with minimal bleeding risk and complication rate.
Short Hospital Stay: Most patients can be discharged the same day.

Disadvantages

There may be a partial decrease in voice quality.
In very advanced cases, laser surgery may be insufficient and other surgical approaches may be required.

Things to Consider After Treatment

After laser surgery, patients should use their voice carefully and follow the rehabilitation programs recommended by the doctor. After treatment, attention is usually paid to the following:

Physical activities are temporarily limited.
With voice therapy, residual voice function can be optimized.
A doctor’s check-up should be done at regular intervals.

Conclusion

Bilateral vocal cord paralysis is an important problem that affects both the social and physical life of the individual. Laser surgery is an effective treatment option to solve the breathing problem in this disease. With modern techniques and the right approach, this surgical procedure can improve the quality of life of patients.

If you or a loved one is struggling with bilateral vocal cord paralysis, you can get information about laser surgery by contacting a specialist. Remember, it is possible to regain your breath with the right treatment!

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Duration of surgery 2 hours
Type of surgery Endoscopic
Anesthesia General Anesthesia
Hospitalization 1 day
When to return to work: Day 7
Full recovery time: 3-6 months
Duration of persistence Lifetime