[The evaluation of intracordal silicone injection in patients with postoperative recurrent nerve paralysis].

This study aimed to evaluate the usefulness and efficacy of intracordal silicone injection in the treatment of cordal paralysis after thoracic surgery or due to tumor invasion of the recurrent nerve. A total of twenty two patients with cordal paralysis was treated with this procedure. The cause of the cordal paralysis was injury to the recurrent nerve incurred during operation for oesophageal or lung cancer in nineteen patients, and direct invasion of malignant neoplasm to the recurrent nerve in the other three patients. Among the nineteen postoperative patients, fifteen underwent silicone injection 15 to 75 days after thoracic operations during hospitalization. The other four patients were treated after discharge from the hospital. The complaints of the fifteen patients who were treated during hospitalization were dysphonia, aspiration and inability to remove sputum. After treatment, dysphonia had improved in all of these fifteen patients, and aspiration had disappeared in thirteen patients. In four patients who were treated with this procedure 7 months following thoracic operation and three who had cordal paralysis due to invasion of malignant tumors, in all of whom aspiration had not been noted, dysphonia disappeared completely after the silicone injection. To evaluate the effect of silicone injection on the patients' cough force, the intratracheal pressure during cough was measured in patients before and immediately after the treatment. The maximum intrathecal pressure was 25 (+/- 16.57) mmHg before silicone injection. After the procedure, the maximum pressure rose to 95 (+/- 18.13) mmHg. Following the procedure, the patients who had suffered severe debilitating aspiration could remove sputum easily.