Concept for Diagnosis and Therapy of Unilateral Recurrent Laryngeal Nerve Paralysis Following Thoracic Surgery

B. Schneider; B. Schickinger-Fischer; M. Zumtobel; G. Mancusi; W. Bigenzahn; W. Klepetko; A. End

doi:10.1055/s-2003-45426

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2003; 51(6): 327-331
DOI: 10.1055/s-2003-45426

Original Thoracic

Concept for Diagnosis and Therapy of Unilateral Recurrent Laryngeal Nerve Paralysis Following Thoracic Surgery

B. Schneider¹ , B. Schickinger-Fischer¹ , M. Zumtobel² , G. Mancusi¹ , W. Bigenzahn¹ , W. Klepetko² , A. End²

¹Department of Otorhinolaryngology, Section of Phoniatrics-Logopedics
²Department of Surgery, Division of Cardiothoracic Surgery, University Hospital of Vienna, School of Medicine, Austria

The paper was presented at the 32nd Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery held in February 2003 in Leipzig, Germany.

Abstract

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Abstract

Background: Injury to the recurrent laryngeal nerve is a potential complication in thoracic surgery, and may lead to postoperative dysfunction due to the resulting insufficient glottal closure. The aim of this study was, first, to develop an interdisciplinary concept of early diagnosis and adequate therapy of recurrent laryngeal nerve paralysis (RLNP), and second, to investigate efficiency of this approach. Methods: 120 patients (77 male, 43 female) aged between 15 and 85 years (mean 57 years) were examined otolaryngologically before and after thoracic surgery. Individual therapeutic modalities were chosen according to established criteria. Results: In 18 patients (15 %), RLNP was found (16 left, 2 right). Five had already been diagnosed preoperatively. Functional voice therapy, stimulation-current therapy or external vocal fold medialization was performed depending on the prognostic criteria. Conclusions: RLNP following thoracic surgery requires immediate diagnosis and therapeutic strategy to minimize postoperative complications and to overcome impairments in the voice, swallowing, and coughing. The interdisciplinary concept presented in this study is especially advisable in high-risk RLNP procedures.

Key words

Thoracic surgery - recurrent laryngeal nerve paralysis - postoperative complication - unilateral vocal fold palsy

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Berit Schneider,MD

University Hospital of Vienna Medical School, Department of Otorhinolaryngology, Section of Phoniatrics-Logopedics,

Waehringer Guertel 18-20

1090 Vienna, Austria

Phone: +43 (1) 404 00 33 10

Fax: +43 (1) 404 00 33 32

Email: Berit.Schneider@akh-wien.ac.at