Endoscopic assisted Lateropexy for Bilateral Abductor Paralysis in a Low Resource Setting: Report of two cases from Abubakar Tafawa Balewa university teaching hospital Bauchi

Human larynx plays a vital role in phonation, breathing, airway protection, and generate high intra-thoracic pressure for coughing and lifting objects. Injury to the vagus nerve or recurrent laryngeal nerve results in vocal fold paralysis. There are several causes of vocal fold paralysis reported in the literature, which include: thyroidectomy, benign and malignant thyroid diseases, oesophageal carcinoma, neck trauma, bronchogenic cancer, aortic aneurysm, intra-thoracic surgery, idiopathic and congenital vocal cord paralysis. Management of vocal paralysis is surgical, the surgical approaches evolved from open to endoscopic procedures. A 37 year old woman who presented with progressive difficulty with breathing following thyroidectomy she had two years ago for a benign thyroid lesion. The difficulty with breathing was said to have started immediately after extubation necessitating an emergency tracheostomy and admission at the Intensive Care Unit. The patient was seen at the Laryngology clinic about six weeks before having the thyroplasty. She had flexible nasopharyngolaryngoscopy from a nearby Teaching hospital which showed completely immobile right true vocal cord and a sluggishly mobile left vocal cord. She had laboratory investigations and had endoscopic assisted thyroplasty on 26th November 2020 and was decanulated. Has been discharged and had two uneventful follow-ups.