A case of bilateral vocal cord paralysis in which traction thread broke 11 years after Ejnell's operation

Abstract

We herein report a case of bilateral vocal cord paralysis in which the traction thread broke 11 years after Ejnell's operation. A woman with bilateral vocal cord paralysis after total thyroidectomy underwent Ejnell's operation at 61 years of age. The left vocal cord was pulled outward with a 3-0 nylon thread and the thread was ligated onto the thyroid cartilage. After the operation, the glottis was widened and the tracheostoma was closed. The patient at 72 years of age visited our clinic 11 years after the operation owing to breathing difficulty and wheezing upon exertion. The left vocal cord was almost in the median position. It was speculated that the traction thread broke or became loose. While waiting for re-operation, she complained of throat irritation and developed a cough. The stump end of the nylon thread protruded into the glottis endoscopically ; therefore, it was removed with endoscopic biopsy forceps. After tracheotomy, left partial submucosal arytenoidectomy was performed, and the posterior glottis was widened. When following up a patient who underwent Ejnell's operation, it is necessary to inform the patient of the possibility that the traction thread may break even several years after the operation.