Abstract
We herein report that a cricopharyngeal myotomy combined with phonosurgery improved the symptoms of hoarseness and dysphagia in patients with Wallenberg syndrome. A 65-year-old man with Wallenberg syndrome had been suffering from hoarseness and severe dysphagia for 2 years. He had left vocal cord paralysis and had undergone a gastrostomy to prevent aspiration. Although it is often observed that hoarseness and dysphagia for Wallenberg syndrome tends to naturally improve overtime, surgical treatment is also a useful option in an intractable case. As vocal cord paralysis is closely related to dysphagia, phonosurgery is an effective surgical treatment for dysphagia. In addition, we can also perform a myotomy in the same field of operation. We performed arytenoid ad- duction with thyroplasty type 1 in this case, because of the presence of a large glottal chink and severe atrophy of the vocal cord. In order not to interfere with arytenoids adduction, we performed thyroplasty type 1 with the insertion of Goretex from the outside of the lower part of the thyroid cartilage without injuring the thyroid cartilage. After these operations, the patient's hoarseness improved and he was able to eat without any complications. This method is therefore useful for the treatment of hoarseness and dysphagia in patients with Wallenberg syndrome.
