VOCAL CORD MEDIALIZATION FOR UNILATERAL PARALYSIS ASSOCIATED WITH INTRATHORACIC MALIGNANCIES

Patients with unilateral vocal cord paralysis from intrathoracic malig nancies may have significant dysfunctions of speech, swallowing, venti lation, and effective coughing as a result of inadequate compensation of the nonparalyzed cord, In patients with already compromised pulmona ry function, aspiration can be a life-threatening event, Sixty-three p atients with intrathoracic malignancies required surgical correction o f vocal cord paralysis, Primary pathology included lung cancer (49), e sophageal cancer (nine), and miscellaneous tumors (five), Symptoms inc luded hoarseness (62), dyspnea (21), aspiration (26), weight loss (19) , dysphagia (14), and pneumonia (14), The surgical procedures included medial displacement of the vocal cord with silicone elastomer (48), t emporary Gelfoam injection (seven), and Teflon (polytetrafluoroethylen e) injection (eight) to move the affected cord to a medial position, I n 11 patients, the operation was performed in the acute postoperative setting to improve pulmonary toilet, Symptomatic improvement was noted in the following proportions of affected patients: hoarseness, 92%; d yspnea, 90%; dysphagia, 93%; aspiration, 92%; pneumonia, 93%; and weig ht loss, 47%, Overall success rate of the intervention was 57 of 63 pa tients (90%). All 11 patients treated in the acute setting had immedia te improvement, A variety of complications occurred in 17% of patients , Surgical management of vocal cord paralysis in patients with intrath oracic malignancies prevents life-threatening pulmonary complications in the acute postoperative setting, In chronic situations, it provides patients with improved speech, swallowing, and pulmonary function, re sulting in improved quality of life, even for patients not cured of th eir disease.