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ENT Larynx a9c4084e

What is the treatment of unilateral vocal cord paralysis?

A
Speech therapy
B
Urgent tracheostomy
C
Total laryngectomy
D
Cordectomy
High-Yield Explanation
Ans. is 'a' i.e., Speech therapy Combined (complete) paralysis (RLN & SLN paralysis) of vocal cords1) Unilateralo All the muscles on one side of the larynx are paralysed - Vocal cord lies in cadaveric (intermediate) positiono There is complete anesthesia of larynx on affected side.o The healthy cord is unable to approximate the paralysed cord, thus causes glottic incompetence which results in hoarseness of voice and aspiration of liquids through the glottiso Treatment includes:-i) Speech therapyii) Medialization of cord:- The aim is to bring the paralysed cord towards the midline so that healthy cord can meet it and can prevent aspiration. This is achieved by - i) Injection of teflon paste lateral to the paralysed cord; ii) Thyroplasty type I; iii) Muscle or cartilage implant; or iv) Arthrodesis of cricoarytenoid joint.2) Bilateralo All the laryngeal muscles of both sides are paralysed and there is complete anaesthesia of whole larynxo This results ini) Aphoniaii) Aspirationiii) Inability to coughiv) Bronchopneumoniao Treatment includes : -i) Tracheostomyii) Epiglottopexyiii) Vocal cord plicationiv) Total laryngectomyv) Diversion procedures

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