Application of Red Pulsed Laser Therapeutic Radiation for Healing Larynx Bilateral Paralysis After Stringectomy

摘要

The study aim was to increase the effectiveness of surgical treatment and rehabilitation of patients with bilateral paralysis of the larynx by applying low-intensity laser radiation of the visible red spectrum in the pulsed mode in this category of patients in the postoperative period. There were healed 18 female patients with bilateral paralysis of the larynx, 14 of them was tracheotomized, 4 of them - wasn't. According to the method of surgical intervention, the patients were divided into 2 groups. The first one includes 9 female patients who had chordaritenoidotomy with coblator. The second one includes 9 female patients who had chordaritenoidotomy with microsyrgery tools. All of patients had antiphlogistic therapy after operation, 5 patients from each group also had additionally low-intensity laser radiation therapy with device 《Mustang 2000》. On the third and tenth day patients had Doppler laser flowmetry, considering variation coefficient (Kv). On the third day 4 patients from each group (who haven't additionally red pulsed laser therapy) have Kv=9, 10 patients (who have additionally red pulsed laser therapy) - Kv=13. On the 10 day the first ones had Kv=26, the second ones - Kv=32. The criteria for the effectiveness of postoperative treatment were the quality and timing of wound healing, the absence of cicatricial measurements in the long-term postoperative period, and the normalization of respiratory function. After 4 months both groups have such complications as cicatricial stenosis of vocal folds and underfolds area, polypus of vocal folds. In 10 patients receiving laser therapy, no complications were observed. In conclusion it can be said that the method of surgical intervention (in the first group - chordaritenoidotomy with the cold-plasma apparatus cobblator, in the second group - chordaritenoidotomy with instruments for microsurgery of the larynx) practically does not affect the final result. Laser therapy is an important factor in the activation of regenerative processes in the postoperative area.