Laser arytenoidectomy for bilateral vocal fold palsy in Parkinson's disease

Abstract

We report a case of laser arytenoidectomy for bilateral abductor palsy of the vocal fold in a patient with Parkinson's disease. Parkinson's disease is known to be a rare cause for bilateral vocal fold palsy and this is the second case reported in the English literature. Majority of the reports to date are in the non-English literature. Tracheostomy has been the classic treatment option offered to these patients. To date no report has been found in the literature about a laser arytenoidectomy being performed in a patient suffering from bilateral vocal fold palsy in Parkinson's disease. We have suggested this option as it improves the quality of life of the individual and avoids the difficulty faced by a Parkinson's patient in managing tracheostomy care due to bradykinesia, rigidity and tremor.

Laser arytenoidectomy and posterior cordotomy in a patient with bilateral vocal cord paralysis due to multiple system atrophy

“…Patients need training from specialist nurses and Speech and Language therapists in order to manage the stoma and the tubing. The tremor associated with PD and MSA results in this becoming an even greater challenge 1. The treatment offered to our patient helped him avoid a tracheostomy and maintain his quality of life.…”

“…Single case reports describe laser arytenoidectomy in a patient with MSA7 and in a patient with PD 1. However, in both these cases, a tracheostomy was performed simultaneously.…”

Effects of deep brain stimulation on vocal fold immobility in Parkinson's disease

“…The finding of bilateral VF immobility and respiratory stridor reported here, although rare, is a potentially fatal complication of advanced PD. [4101214202123] Moreover, the potential effects of neuromodulation on VF immobility are largely unknown.…”

“…[156] Reports of respiratory stridor and vocal fold (VF) immobility in PD are rare but raise important clinical concerns regarding patient care. [4101214202123] The potential effects of DBS on VF immobility remain unknown. We report a case of a PD patient with stridor secondary to bilateral VF immobility ultimately requiring a tracheostomy.…”

Stridor in Parkinson's disease: a case of ‘dry drowning’?

“…The mechanism of stridor in these patients appears different from that in our patient. 19 Successful decannulation was achieved six weeks later, with a weaker voice but no aspiration. When stridor is periodic, for example in laryngospasm, extrinsic causes should be sought and managed, including excessive secretions and LPR.…”