EARLY INDICATION FOR INITIATING PHONOSURG ICAL TREATMENT OF UNILATERAL VOCAL CORD PARALYSIS IN ELDERLY PATIENTS

Background: Unilateral vocal cord paralysis is usually treated conserv atively. Phonosurgery is not indicated before 1 year after the onset o f the palsy as during this period spontaneous recovery can be expected . In the elderly patient conservative voice rehabilitation is often li mited by a restricted general condition. In these cases a severe commu nication disorder may result unless vocal cord function recovers spont aneously. Patients and methods: In 4 patients aged 68 to 79 years who had suffered from iatrogenic unilateral vocal cord paralysis for 6 to 9 months, surgical medialisation of the paralysed vocal cord was carri ed out in local anaesthesia as an Isshiki-Type-1-operation after unsuc cessful conservative treatment prior to surgery. Results: In all cases a definite amelioration of voice function could be reached. There wer e no focal or general complications. No spontaneous recovery of nerve function could be detected by electromyography between 6 to 9 months a fter the operation. Voice function remained stable during this period. Conclusions: We conclude that in elderly patients with unilateral voc al cord paralysis with no signs of spontaneous recovery and unsuccessf ul conservative treatment, surgical voice rehabilitation may be indica ted before 1 year after the onset of the palsy.