Endoscopic assisted microscopic posterior cordotomy for bilateral abductor vocal fold paralysis using radiofrequency versus coblation

Eur Arch Otorhinolaryngol. 2024 Feb;281(2):835-841. doi: 10.1007/s00405-023-08331-z. Epub 2023 Dec 2.

Abstract

Purpose: To assess the outcomes of endoscopic assisted microscopic posterior cordotomy for bilateral abductor vocal fold paralysis (BAVFP) using radiofrequency versus coblation.

Methods: This was a randomized prospective cohort study that carried out on 40 patients with BAVFP who were subjected to endoscopic/assisted microscopic posterior cordotomy. The patients were randomly allocated into two groups: group (A) patients were operated with radiofrequency, and group (B) patients were operated with coblation. Glottic chink, grade of dyspnea, voice handicap index 10 (VHI10), and aspiration were evaluated pre-operatively and 2 weeks and 3 months post-operatively.

Results: There was a significant improvement in the glottic chink and VHI10 scores postoperatively with a non-significant difference between both groups regarding the degree of improvement. In addition, there was a significant improvement of the grade of dyspnea with a non-significant impact on the degree of aspiration in both groups post operatively. There was a lower incidence of oedema and granulation formation in the coblation group but without a statistical significance.

Conclusion: Both techniques are effective alternatives for performing posterior transverse cordotomy in cases of BAVFP.

Keywords: Bilateral abductor paralysis; Coblation; Posterior cordotomy; Radiofrequency; Vocal fold paralysis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cordotomy / adverse effects
  • Cordotomy / methods
  • Dyspnea / etiology
  • Dyspnea / surgery
  • Humans
  • Laryngoscopy / methods
  • Prospective Studies
  • Respiratory Aspiration / complications
  • Treatment Outcome
  • Vocal Cord Paralysis* / complications
  • Vocal Cord Paralysis* / surgery
  • Vocal Cords* / surgery
  • Voice Quality