A Clinical Analysis of the Posterior Glottic Adhesion

Abstract

Over the past 23 years a clinical study of posterior glottic adhesion, involving 127 patients who visited the speech and voice clinic of Kurume University Hospital, was conducted. According to the patients' past history of tracheal intubation, recurrent surgical nerve dissection and spontaneous recorvery, they were divided into two groups; the adhesion group and the paralysis group. For these two groups, our observations consisted of the following : the position of the vocal cords; electromyograms (EMG) of the larynx, endoscopic evidence, indication of tracheostomy, vocal function and surgical treatment for glottic adhesion.
In the adhesion group, there were many patients whose vocal cords were fixed at the paramedian position and had received tracheostomy. In vocal function tests, the MPT of the paralysis group was longer than that of the adhesion group.In most of the adhesion cases, surgical separation of the adhesion was ineffective. In the vocal cord paralysis group, many had spontaneous recovery of vocal function and, as a result, the tracheostomy could be closed. These findings indicated that vocal cord traction test under a direct laryngoscopy was a valuable preoperative method for discriminating between vocal cord adhesion and paralysis.