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Bilateral Abductor Vocal Fold Palsy

Acute Laryngitis Effects on Bilateral Abductor Vocal Fold Palsy

Figure A - at rest.

Figure B - during inspiration.

 

Figure C - at rest.

 

Figure D - close-up.

 

Figure A and B are images during active acute laryngitis.  Note inflamed supraglottic mucosa with very oedematous arytenoids and tight glottic chink (worse during inspiration).

Figure C and D are images upon resolution of acute laryngitis (1 week apart).

Posterior Cricoarytenoid Muscles on Excised Human Larynx Specimen

 

Abductor Vocal Fold Palsy: Outline of Posterior Cordectomy

  

CO2-Laser Posterior Cordectomy

 

 Watch video on homeostasis during laser cordectomy @ YouTube

Another example of laser cordectomy; before and after surgery respectively.

Radiofrequency Posterior Cordectomy

       At completion of surgery.                            Postoperative Day 1.

 

Bipolar radiofrequency device was used for this case

set at 5W cut/coagulation mode with arytenoid cartilage preserved.

CO2-Laser Posterior Cordectomy with Partial Arytenoidectomy for Bilateral Abductor Vocal Folds Palsy

Before Surgery 

After Surgery

 Remnant of right arytenoid cartilage (arrow) after its vocal process removed. 

Glottic view after the operated side healed [right side].

CO2-Laser Posterior Cordectomy with Partial Arytenoidectomy for Bilateral Abductor Vocal Folds Palsy: An Intraoperative View with Patient Having Cuffed Tracheostomy Tube In-Situ

Pre-operative view.

Immediate post-operative view.

(LVF - left vocal fold, RVF - right vocal fold, A - arytenoid complex, L -left, R - right)

CO2-Laser Posterior Cordectomy with Subtotal Arytenoidectomy

Method to Apply Tisseel after CO-2 Laser Subtotal Arytenoidectomy of Transoral Oncologic Surgery

Cordectomy-Related Lesions

 

Fibrin exudate formation is a normal phenomena seen after CO2-laser cordectomy performed.  It occurs as part of healing process until epithelialization is completed.

Well-formed left posterior cordectomy with partial arytenoidectomy complicated by small granulation tissue.  Trial of proton-pump inhibitor should be given and response monitored closely.  Non-responsive and obstructing granuloma

needs to be removed surgically.

 

Watch video on compensatory voice mechanism post-cordectomy @ YouTube

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