• Users Online: 125
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
Year : 2016  |  Volume : 4  |  Issue : 1  |  Page : 23-28

Laser-assisted posterior cordotomy for bilateral vocal fold paralysis: Our experience

Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Nitish Virmani
H. No. 576, Sector-37, Faridabad - 121 003, Haryana
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2347-8128.182852

Rights and Permissions

Introduction: Bilateral vocal fold paralysis (BVFP) is a relatively uncommon cause of respiratory distress. The goals of surgical treatment are an improvement in airway size by enlarging the glottis, thus, eliminating the need for tracheostomy, while at the same time avoiding a breathy voice and aspiration. Striking this balance is extremely important. Unilateral laser-assisted posterior cordotomy provides sufficient airway at posterior glottis while preserving phonatory and protective functions of the larynx. Aims: To evaluate long-term acoustic, aerodynamic and functional results of laser-assisted unilateral posterior cordotomy in BVFP. Materials and Methods: The prospective study includes seven patients of BVFP who underwent unilateral laser-assisted posterior cordotomy. Surgical success was evaluated regarding decannulation rate, time to decannulation and need for the second procedure. Voice assessment was done using voice handicap index (VHI), grade, roughness, breathiness, asthenia, strain and measurement of maximum phonation time (MPT). Effect of deglutition was assessed by the presence or absence and duration of aspiration. Observations and Results: Of seven patients, four had been tracheostomized at some time during their treatment. They were successfully decannulated within an average of 1 week after the surgery. The postoperative respiratory function was adequate for more than routine activity in all patients. None of the patients required a second procedure. VHI values demonstrated that while four patients had no/mild degree of voice handicap, two had moderate and one had a severe degree of handicap. While five patients had a normal MPT, two had a reduced MPT. Perceptual rating by a speech pathologist revealed that while two patients had mild dysphonia, four had moderate dysphonia. None of the patients complained of aspiration postoperatively. Conclusion: Unilateral CO2laser posterior cordotomy is a simple, safe and short surgical technique that creates a satisfactory glottic airway to improve respiration while avoiding aspiration and having minimal to the mild effect on the voice.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded485    
    Comments [Add]    
    Cited by others 3    

Recommend this journal