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.