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Vocal fold paralysis: role of bilateral transverse cordotomy

Published online by Cambridge University Press:  10 September 2009

Y Bajaj ,
N Sethi ,
A Shayah ,
A T Harris ,
P Henshaw ,
A P Coatesworth  and
A R Nicolaides
Y Bajaj*
Affiliation:
Department of Otolaryngology, York Hospital, UK
N Sethi
Affiliation:
Department of Otolaryngology, York Hospital, UK
A Shayah
Affiliation:
Department of Otolaryngology, York Hospital, UK
A T Harris
Affiliation:
Department of Otolaryngology, York Hospital, UK
P Henshaw
Affiliation:
Department of Otolaryngology, York Hospital, UK
A P Coatesworth
Affiliation:
Department of Otolaryngology, York Hospital, UK
A R Nicolaides
Affiliation:
Department of Otolaryngology, York Hospital, UK
*
Address for correspondence: Mr Y Bajaj, 2 Tall Trees, Leeds LS17 7WA, UK. Fax: 01132663305 E-mail: [email protected]
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Abstract

Objective:

Although modern endoscopic laser techniques aim to avoid a permanent tracheostomy by augmenting the glottic aperture in cases of bilateral vocal fold palsy, loss of tissue from the posterior glottis risks compromising voice quality and swallowing function. The objective of this study was to describe our experience with bilateral transverse posterior cordotomy.

Methods:

This was a retrospective analysis of functional outcomes in a series of consecutive patients undergoing a simple modification of the classical laser cordectomy procedure, which avoids tissue loss. The procedure was confined to the complete release of the vocal ligament from the arytenoid cartilage on both sides, while avoiding any significant loss of mucosa or cartilage.

Results:

Post-operative voice quality and quality of life were rated as good by most patients, which makes bilateral transverse cordotomy an attractive treatment option for bilateral vocal fold paralysis.

Conclusion:

Bilateral transverse cordotomy is a reliable treatment option for patients with bilateral vocal fold paralysis, and aims to avoid the morbidity associated with a permanent tracheostomy.

Keywords

Vocal Cord ParalysisVocal CordsCordotomyArytenoid Cartilages
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 12 , December 2009 , pp. 1348 - 1351
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Thornell, WC. Intralaryngeal approach for arytenoidectomy in bilateral abductor vocal cord paralysis. Arch Otolaryngol 1948;47:505–8CrossRefGoogle Scholar
2Ossoff, RH, Duncavage, JA, Shapshay, SM. Endoscopic laser arytenoidectomy revisited. Ann Otol Rhinol Laryngol 1990;99:764–71CrossRefGoogle ScholarPubMed
3Dennis, DP, Kashima, H. Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 1989;98:930–4CrossRefGoogle ScholarPubMed
4Kashima, HK. Bilateral vocal fold motion impairment: pathophysiology and management by transverse cordotomy. Ann Otol Rhinol Laryngol 1991;100:717–21CrossRefGoogle ScholarPubMed
5Wilson, JA, Webb, A, Carding, PN, Steen, IN, MacKenzie, K, Deary, IJ. The Voice Symptom Scale (VoiSS) and the Vocal Handicap Index (VHI): a comparison of structure and content. Clin Otolaryngol 2004;29:169–74CrossRefGoogle ScholarPubMed
6Weymuller, EA Jr, Alsarraf, R, Yueh, B, Deleyiannis, FWB, Coltrera, MD. Analysis of the performance characteristics of the University of Washington Quality of Life Instrument and its modification (UW-QOL-R). Arch Otolaryngol Head Neck Surg 2001;127:489–93CrossRefGoogle ScholarPubMed
7Steiner, W, Ambrosch, P. Endoscopic Laser Surgery of the Upper Aerodigestive Tract, with Special Emphasis on Tumour Surgery. Stuttgart: Thieme, 2000Google Scholar
8Wang, S, Zhou, S, Xu, Y. Cordotomy for bilateral cord abductal paralysis. Chin Med J 2001;114:542–3Google ScholarPubMed
9Bosley, B, Rosen, CA, Simpson, B, McMullin, BT, Gartner-Schmidt, JL. Medial arytenoidectomy versus transverse cordotomy as a treatment for bilateral vocal fold paralysis. Ann Otol Rhinol Laryngol 2005;114:922–6CrossRefGoogle ScholarPubMed
10Laccourreye, O, Paz Escovar, MI, Gerhardt, J, Hans, S, Biacabe, B, Brasnu, D. CO2 laser endoscopic posterior partial transverse cordotomy for bilateral paralysis of the vocal fold. Laryngoscope 1999;109:415–18CrossRefGoogle ScholarPubMed