Abstract
The authors examined 601 patients with recurrent laryngeal nerve paralysis (RLNP) between October 1976 and June 2001 at the Ehime University Hospital and Kumamoto University Hospital. The number of male patients was 1.3 times greater than that of female patients. Their ages ranged between 2 months and 87 years, with patients in their sixties and seventies being most frequent. RLNP patients whose problem was related to surgery totaled 27.3% in the first 10 years, while between 1986 and 1997, they totaled 50.6% and between October 1998 and June 2001 occupied 47.0%. Thus, RLNP problems related to surgery showed an increasing tendency. Thyroid surgery, intubation, and surgeries for esophageal cancer, cardiovascular diseases and lung cancer were the major frequent etiologies of RLNP related surgery, in this order. Even when these diseases were successfully treated, RLNP sometimes persisted to cause severe hoarseness, resulting in a deterioration in the patient's quality of life. The authors performed phonosurgical treatments such as arytenoid adduction and type I thyroplasty for 71 RLNP patients Although the phonatory functions of these patients improved after the treatment, nearly half of them did not reach a normal range of phonatory function. Three of the 38 patients who underwent arytenoid adduction had postoperative dyspnea and received a tracheostomy. Local edema and insufficient abdution of the vocal fold on the healthy side seemed to be a cause of dyspnea in one patient. The other two both had a history of esophagectomy and reconstruction with a gastric tube. The causes of their sudden dyspnea was considered to be laryngospasms resulting from the regurgitation of gastric juice.
