One hundred eighty‐one patients with unilateral or bilateral vocal cord paralysis unrelated to laryngeal carcinoma or its therapy were studied. The orderly diagnostic profile used to delineate cause of the paralysis includes CBC, VDRL blood sugar profile, latex fixation and serum sampling for toxic heavy metals. The radiologic and endoscopic evaluation is done to completion unless contraindicated, to assess aspiration as well as to observe laryngopharyngeal structures which may cause the paralysis. This evaluative profile defined the etiology of cord paralysis in 80 percent of patients, despite exclusion of viral disease as a cause subsequent to upper respiratory infection. Blunt trauma and previous neck surgery each were responsible for 23 percent of the cases. Fifty‐four patients had bilateral paralysis of which 22 were post thyroidectomy. Surgical repair for cord paralysis was symptomatic, and included 28 successful teflon injected cords. Recurrent laryngeal nerve decompression was successful in four of five operations and arytenoidectomy was performed in 39 patients.
A major complication of head and neck cancer surgery following radiation and extensive resection is pharyngocutaneous fistula. A retrospective analysis of 36 fistula patients out of 376 major head and neck procedures between January 1971 and July 1973 revealed certain guidelines for improved clinical management. Since a large discrepancy existed in the incidence of fistulas between the different surgical procedures, each operative group was examined separately. The incidence, predisposing factors, and methods of treatment for this complication following composite jaw-neck resections and various laryngeal procedures are analyzed and discussed.
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