INDIRECT LARYNGOSCOPIC EVALUATION OF VOCAL CORD FUNCTION IN PATIENTS UNDERGOING TRANSHIATAL ESOPHAGECTOMY

Vocal cord function was assessed by indirect laryngoscopy before and a fter transhiatal esophagectomy for carcinoma of the middle and lower e sophagus. Unilateral vocal cord palsy was found in 16 (34 percent) of 47 patients, but three of these patients were not hoarse and coughed n ormally. Four patients were hoarse postoperatively but had normal. voc al cord function on indirect laryngoscopic examination. Ah vocal cord palsies but one were on the left side and the left side of the neck wa s used for esophageal mobilization with the only exception of the one patient who had a right cord palsy after a right-sided neck dissection . Patients with impaired vocal cord function did not have a significan tly increased stay in the intensive therapy unit or in the hospital, n or was there an increase in pulmonary complications. Vocal cord palsy is a recognized complication of transhiatal esophagectomy, and althoug h it remains unresolved whether or not the recurrent laryngeal nerve d amage occurs at the level of the aortic arch or in the neck, the prese nt evidence suggests the latter site. The clinical impression of posto perative vocal cord palsy is often incorrect.