A patient presented with stridor and dyspnea which he developed after an attack of upper respiratory tract infection. On examination, he was found to have a 3 mm glottic opening. All of the following are used in the management except -
High-Yield Explanation
The glottic diameter of 3 mm suggests that the vocal cord is in an adducted position most probably due to RLN paralysis after an upper respiratory tract infection (Normally quiet breathing requires 6-12 mm glottic opening).
Symptoms like stridor and dyspnea also indicate the same diagnosis, i.e., airway obstruction due to Bilateral RLN paralysis.
Treatment options for bilateral RLN paralysis are : -
Tracheostomy
Lateralization of cord: Arytenoidectomy , Thyroplasty type II, Cordectomy, nerve muscle implant, lateralization through the endoscope.