A comparative study of laser posterior cordotomy and combined laser posterior cordotomy with suture lateralization in bilateral vocal cords abductor paralysis

Abstract

Background: A prospective randomized study was conducted on 40 patients with true bilateral vocal fold abductor paralysis. The patients under the study were divided into 2 groups, group (A) including 20 patients who underwent laser posterior cordotomy and another group (B) including 20 patients who underwent combined laser posterior cordotomy with suture lateralization, the patients under the study presented at otorhinolaryngology outpatient clinic at faculty of medicine, Cairo University. The study was conducted in the period from January 2018 till January 2021.

Results: No significant difference between both surgeries regarding respiratory efficiency, voice handicap index (VHI) scores, and presence of postoperative aspiration. A significant difference was found regarding some Computerized Speech Lab (CSL) measures (there is a statistically significant difference between the 2 groups in favor of group (b) regarding N to H ratio in week 2 postoperatively and maximum phonation time in 4-week postoperatively) and granuloma formation (granuloma formation was more common in the group (A) than group (B)).

Conclusion: Combined laser posterior cordotomy with suture lateralization in bilateral vocal folds abductor paralysis showed fewer complications and better maximum phonation time and a comparable effect to laser cordotomy regarding respiration.

Keywords: Bilateral vocal fold paralysis; Combined laser posterior cordotomy with suture lateralization; Laser posterior cordotomy; Respiratory distress; Voice quality.