7th European Laryngological
Live Surgery Broadcast

23th November 2022 | 9.00 - 16.00 CET (GMT+1)


Case
Dr Yakubu Karagama (London)

Centre: Guy's and St Thomas' Hospital, London

Principal surgeon: Mr Yakubu Karagama, Consultant Laryngologist and ENT Surgeon
Assistants: Miss Shiying Hey, Senior Laryngology Fellow, Dr Carlo Robotti, Senior Laryngology Fellow

Microlaryngoscopy + CO2 laser left partial arytenoidectomy +/- suture lateralisation + steroid injection + balloon dilatation (Twinstream ® ventilation)

Patient: 76F,retired. (Ms T)
Background: Bilateral vocal cord immobility since 2010 following total thyroidectomy indicated for large goitre with tracheal compression. Despite suffering from breathing difficulty, patient had previously declined surgery offered to her at another hospital, due to a concern of losing her voice and the subsequent impact on her work. She had chosen in the past few years a conservative management approach with extensive speech and language therapy input.
As her breathing becomes progressive worse, she has inspiratory stridor present at rest. She was referred to our centre and is now keen to consider further management.

PROM: VHI-10 5, RSI7, EAT-10 1, AVS scale 421
Assessment: Videostrobolaryngoscopy demonstrated bilateral abductor vocal cord paralysis with narrowed glottic space.
FEES (Oct'23) : Mild pharyngeal dysphagia secondary to delayed swallow trigger with fluids and mildly reduced pharyngeal clearance. Trace penetration but no convincing aspiration across consistencies.

Outcome: Following an extensive discussion, a joint decision was made to proceed with glottic widening surgery to improve her airway and more importantly, her quality of life after retirement.


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