Etsuyo Takayama

Voice prognosis after liquid and solid silicone injection

A study was undertaken to determine the voice prognosis in 51 of the 408 patients with unilateral recurrent laryngeal nerve paralysis who had visited the Department of Ear, Nose and Throat at Keio University between 1977 and 1984. The 51 patients were divided into three groups: 18 patients without silicone injection, 15 with a silicone liquid implant, and 18 with a silicone solid implant. Data are provided to show that (1) both types of silicone implant are tolerated by the body and effective in improving voice and that (2) the liquid implant is ultimately absorbed and therefore useful for temporary voice improvement in patients in whom the prognosis for vocal fold paralysis is not known, whereas the solid implant is not absorbed and is therefore effective in the long term when recovery can be ruled out.

Clinical Observations on Bilateral Recurrent Laryngeal Nerve Paralysis.

A clinical study was conducted on 48 patients with bilateral recurrent laryngeal nerve paralysis, 29 females and 19 males. In 38 patients (79%), the paralysis was seen as surgical or post-operative. In a fairly large number of female patients it occurred after thyroid surgery and in males after surgery for esophageal cancer.This paralysis was often seen in males in the 6th and 7th decades of life, but in females seen from the 4th to 8th decades. Hoarseness was the most common symptom, followed by dyspnea, but dyspnea was never observed if there was more than 2 mm between the vocal folds. There was no significant correlation between the distance between the vocal folds and aspiration. There was also no instance of dyspnea becoming more serious, according to the answers to our questionnaire.