[DYSPHAGIA] transverse vocal cordectomy

[Mspslp@aol.com (Mspslp@aol.com)]

   Need opinions and education regarding:
   81 y/o male, intubated 8-12-00 secondary to hematoma, pneumonia, and subsequent respiratory failure.  PMHX significant for CVA, HTN, DM, and dementia.  Patient fitted with Passy-Muir speaking valve 9-1-00 with good result, valve well tolerated with good volume and vocal quality until 9-27-00.  Then patient began to exhibit increased agitation, desaturation, and strained vocal quality--at times aphonic--during valve wear.
   ENT exam 10-7-00 indicates B/L adductor v.c. paralysis, and "transverse vocal cordectomy" is suggested.  Patient did not evidence any change of status that would explain vocal cord paralysis.  
   Opinions solicited as to what may have caused the problem, what this procedure is, and how it may help.
Mary S. Porter, M.A., CCC
Northern Virginia Community Hospital
Arlington, VA
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