A comparative study of laser posterior cordotomy and vocal cord lateralization

Introduction: The treatment of bilateral vocal cord paralysis continues to be a challenge to the otolaryngologist, head and neck surgeon even today. Numerous surgical procedures have been proposed to improve the patient's airway insufficiency without leaving the patient with a breathy, weak voice or an incompetent larynx. In this study we compared the outcome of laser posterior cordotomy and vocal cord lateralization in a group of bilateral abductor palsy patients. Method: Retrospective as well as a prospective study of 25 patients was carried out. The total of 25 patients was divided into 2 groups, group 1 consisted of 15 patients who underwent vocal cord lateralization with SUTUPAK suture and group 2 consisted of 10 patients who underwent laser assisted posterior partial cordotomy. Results: Thyroidectomy was the commonest cause for bilateral vocal fold paralysis i.e. 80% (20) of cases. Patients who underwent laser posterior cordotomy had 100% successful decannulation rate as compared to 92.8% for vocal cord lateralization patients. Comparison between pre and post operative voice assessment data by WILCOXON SIGNED RANKS test revealed that excepting the parameter of fluctuations/s in F₀, all other parameters were statistically not significant. Conclusion: Laser cordotomy is a superior, reliable and viable alternative to the other lateralization procedures for bilateral vocal fold paralysis.