Cancers take on a variety of forms, distinguished by differen...
While disease of the coronary arteries may occur without ge...
The only sure sign of the presence of this parasite in the int...
Punctures Case I
A.B. received a severe punctured wound by a hook of the size ...
Benign Growths In The Larynx
Benign growths in the larynx are easily and accurately remova...
Instructions To The Patient
Before beginning endoscopy the patient should be told that h...
See Teething. ...
Proteins Or Meats
Proteins, the First Foods. There are proteins, or meats, both...
Polarization Of The Circuit
I have said, in effect, a little above, that, while the curre...
See Fever, Rheumatic. ...
A Rampaging Infection
At the age of 40, John, an old bohemian client of mine, came ...
A Healthy Colon
From my point of view the most amazing part of this whole exp...
Our idea is that this is caused by the soda in the soap used. ...
Foreign Bodies In The Larynx
Laryngeally lodged foreign bodies produce a wheezing respirat...
This is the accumulation of gases in the body, usually caused ...
Anesthesia For Peroral Endoscopy
A dyspneic patient should never be given a general anesthetic...
Amaurosis Paralysis Of The Optic Nerve
Use B D current, moderate force, three or four times, and the...
This arises from the undue contraction of some of the muscles ...
Myocarditis Fibrous Management
The advice he should receive is well understood: to avoid phy...
Sleep And Rest
Why We Need Rest. A most important element in a life of healt...
Category: CHRONIC STENOSIS OF THE LARYNX AND TRACHEA
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Bilateral abductor laryngeal paralysis causes severe
stenosis, and usually tracheotomy is urgently required. In cadaveric
paralysis both cords are in a position midway between abduction and
adduction, and their margins are crescentic, so that sufficient airway
remains. Efforts to produce the cadaveric position of the cords by
division or excision of a portion of the recurrent laryngeal nerves,
have been failures. The operation of ventriculocordectomy consists
in removing a vocal cord and the portion or all of the ventricular
floor by means of a punch forceps introduced through the direct
laryngoscope. Usually it is better to remove only the portion of the
floor anterior to the vocal process of the arytenoid. In some cases
monolateral ventriculocordectomy is sufficient; in most cases,
however, operation on both sides is needed. An interval of two months
between operations is advisable to avoid adhesions. In almost all
cases, ventriculocordectomy will result in a sufficient increase in
the glottic chink for normal respiration. The ultimate vocal results
are good. Evisceration of the larynx, either by the endoscopic or
thyrotomic method, usually yields excellent results when no lesion
other than paralysis exists. Only too often, however, the condition is
complicated by the results of a faultily high tracheotomy. A rough,
inflexible voice is ultimately obtained after this operation,
especially if the arytenoid cartilage is unharmed. In recent bilateral
recurrent paralysis, it may be worthy of trial to suture the recurrent
to the pneumogastric. Operations on the larynx for paralytic stenosis
should not be undertaken earlier than twelve months from the inception
of the condition, this time being allowed for possible nerve
regeneration, the patient being made safe and comfortable, meanwhile,
by a low tracheotomy.
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