Original Scientific ArticlesDoes hoarseness of voice from recurrent nerve paralysis after esophagectomy for carcinoma influence patient quality of life?
Section snippets
Methods
This study examined a total of 141 esophageal cancer patients who had undergone a resection by right thoracotomy, laparotomy, and cervicotomy combined with lymphadenectomy between January 1985 and March 1996 and who were cancer free 1 year after surgery. Their vocal cord movements were examined by an otolaryngologist preoperatively, on discharge from the hospital, and yearly after surgery. These inspections were routinely done by indirect examination using a mirror. More detailed observations
Results
The overall time course of healing of vocal cord palsy is shown in Table 1. Of the 51 patients, VCP on discharge was most frequently detected on the left side. VCP on discharge spontaneously healed 1 year after surgery in 21 patients (41.2%), with a mean duration of difficulty in talking 5.7 ± 2.0 months after surgery. The remaining 30 patients still had persistent VCP 1 year after surgery; 4 of the 30 spontaneously healed approximately 2 years after surgery. Spontaneous healing of VCP
Discussion
A systematic dissection of the recurrent nerve lymphatic chains commonly leads to recurrent nerve paralysis that presents itself as hoarseness, which is often deemed to be temporary.8, 9, 10, 11, 12 Neither the responsible site for the paralysis nor when and how the paralysis is restored are clear. In a previous report14 comparing patients who underwent transthoracic esophagectomy with three-field dissection and those without neck lymph node dissection, the rate of cord palsy was not different
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