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Original Investigation |

Comparison Between Laser- and Diathermy-Assisted Posterior Cordotomy for Bilateral Vocal Cord Abductor Paralysis

Nasser Nagieb Mohamed, MD1; Samir Sorour Sorour, MD1; Mohammad Waheed El-Anwar, MD1; Amal Saeed Quriba, MD2; Mohammad Abdou Mahdy3
[+] Author Affiliations
1Department of Otorhinolaryngology–Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2Phoniatric Unit, Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
3resident, Department of Otorhinolaryngology, Al-Ahrar General Hospital, Zagazig, Egypt
JAMA Otolaryngol Head Neck Surg. 2013;139(9):923-930. doi:10.1001/jamaoto.2013.3554.
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Importance  A reliable procedure is needed to solve the problem of difficult airway in patients with bilateral vocal cord paralysis without adversely affecting patient “voice quality.”

Objectives  To compare the results of laser-assisted posterior cordotomy with diathermy-assisted posterior cordotomy for bilateral vocal cord paralysis in regard to dyspnea severity, voice quality, and aspiration.

Design  Prospective randomized clinical trial at a university medical center.

Setting  Zagazig University Hospitals, Zagazig, Egypt.

Participants  Twenty patients randomly categorized into 2 groups; group A was treated with laser-assisted posterior cordotomy and group B was treated with diathermy-assisted posterior cordotomy.

Intervention  Laser-assisted posterior cordotomy for group A and diathermy-assisted posterior cordotomy for group B.

Main Outcome and Measure  Dyspnea severity, voice quality, and aspiration.

Results  A significant difference (P < .05) was found between group A and group B at all postoperative comparisons in dyspnea, whereas no significant difference (P ≥ .05) was detected at all postoperative comparisons in voice quality.

Conclusions and Relevance  Laser-assisted posterior cordotomy can be considered as a reliable and superior procedure compared with diathermy-assisted posterior cordotomy in the treatment of bilateral vocal cord abductor paralysis.

Trial Registration  clinicaltrials.gov Identifier: ISRCTN08093874

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Figures

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Figure 1.
Left Vocal Cord Diathermy-Assisted Posterior Cordotomy

A, Early postoperative view. B, Late postoperative view.

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Figure 2.
Left Vocal Cord Laser-Assisted Posterior Cordotomy

A, Early postoperative view. B, Late postoperative view.

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