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Dr. Andrew Rynne

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Have breathlessness and sleep apnoea. Found bilateral vocal cord paralysis. Should I go for surgery?

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Dr. Ravinder Sharma

ENT Specialist

Practicing since :1992

Answered : 332 Questions

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Posted on Thu, 24 Jan 2013 in Ear, Nose and Throat Problems
Question: Bilateral vocal cord palsy. This has been diagnosed as the cause of my breathlessness and sleep apnoea. Should I opt for surgery? I have had the problems for about 2 years but have just been given this diagnosis as a substitute for COPD previously blamed. What if I decide to take my chances with no further treatment?
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Answered by Dr. Ravinder Sharma 9 hours later
Hi

I am Dr Ravinder Sharma ENT surgeon. On the basis of the information provided I have to say that breathlessness and sleep apnoea can be explained by bilateral vocal cord palsy. It is rare to get sleep apnoea in COPD. It usually presents with breathlessness and common in smokers.

If the diagnosis is bilateral vocal cord palsy the treatment of choice would be either a tracheostomy (is a byepass in airway below the level of vocal cords) or vocal cord lateralization procedure.

COPD usually require medical treatment in the form of bronchodialators and antiallergics. At times of infection an antibiotic is required.

I would advise you to consult a sleep specialist and and go for polysomnography, X XXXXXXX chest PA view, Nasal endoscopy, pharyngoscopy and laryngoscopy for the diagnosis. Once you get the correct diagnosis the right treatment can be initiated.

I hope this answers your concerns. Feel free to contact me if you need further information about it

with regards
Ravinder Sharma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ravinder Sharma 2 hours later
Dear Dr. XXXXXXX

Thank you. I will be having the tests you mention on Monday.my question is...Having lived with bilateral paralysis of the vocal cords, including sleep apnoea and breathlessness for almost two years, should I choose surgery or should I just live with the problem . What is the prognosis if I opt out of surgery?

XXXXXXX
doctor
Answered by Dr. Ravinder Sharma 1 hour later
Hi
Thanks for the follow up of your query
I would advise you to first plan for the tests and a consultation. If the diagnosis comes out to be sleep apnoea syndrome. I would advise you to plan for surgery. Complete paralysis of vocal cords will actually require surgery but a partial paralysis of both vocal cords may give you some space and you can defer surgery. It appears you have partial paralysis of both vocal cords otherwise you would have required surgery by now.
If you do not plan for surgery the problems that can be encountered are
1. Increase in the number of apnoic spells. You may have to get up at night on multiple occassions.
2. Cardiac failure may occur

If you have planned for a non surgical intervention a CPAP / Oxygen concentrator may be of help for you

I hope this answers your concern. Feel free to contact me if you require more information about it

with regards
Ravinder Sharma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ravinder Sharma 8 hours later
I forgot to mention to the ENT consultant that I have been having terrible urinary continence problems. Could they be connected to the laryngeal nerve palsy?
doctor
Answered by Dr. Ravinder Sharma 11 hours later
Thanks for your follow up query
I do not see any co-relation between between laryngeal nerve palsy and urinary incontinence. I would advise you to consult a gynaecologist about it.
I hope this answers your concerns. Feel free to contact me if you require more information about it

with regards
Ravinder Sharma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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