Cordoplasty: A New Technique for Managing Bilateral Vocal Cord Paralysis and Its Comparison with Posterior Cordotomy and External Procedure in a Large Study Group

Abstract

To compare the functional results between posterior cordotomy, cordoplasty and external procedure in managing bilateral vocal cord paralysis in one of the largest published study group. Retrospective and comparative study. 54 patients with bilateral vocal cord paralysis who underwent posterior cordotomy (Group-I), cordoplasty (Group-II) and external procedure (Group-III) from 2001 to 2013 were compared for functional outcomes. Successful decannulation was achieved more in Group-I and II than in Group-III. Voice outcome was better in Group-II patients compared to other groups. Outcomes of cordoplasty was better than posterior cordotomy and external procedures, with acceptable airway and good quality of voice. Posterior cordotomy is preferred in patients without tracheostomy and in pediatric patients. In patients with tracheostomy or who accept temporary tracheostomy, a cordoplasty is preferred for favorable voice. External procedure is preferred for patients not fit for general anesthesia.

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References

  1. 1.

    Joshua B, Feinmesser R, Zohar L, Shvero J (2004) Endoscopic laser assisted posterior ventriculocordectomy without tracheostomy for bilateral vocal cord immobility. Isr Med Assoc J 6(6):336–338

    PubMed  Google Scholar 

  2. 2.

    Benninger MS, Gillen JB, Altman JS (1998) Changing aetiology of vocal fold immobility. Laryngoscope 108(9):1346–1350

    CAS  PubMed  Article  Google Scholar 

  3. 3.

    Shvero J, Koren R, Stern Y, Segal K, Feinmesser R, Hadar T (2003) Laser posterior ventriculocordectomy with partial arytenoidectomy for the treatment of bilateral vocal fold immobility. J Laryngol Otol 117(7):540–543

    CAS  PubMed  Article  Google Scholar 

  4. 4.

    Laccourreye O, Paz Escovar MI, Gerhardt J, Hans S, Bicabe B, Brasnu D (1999) CO2 laser endoscopic posterior partial transverse cordotomy for bilateral paralysis of the vocal fold. Laryngoscope 109(3):415–418

    CAS  PubMed  Article  Google Scholar 

  5. 5.

    Ahmed B, Hydri AS, Malik KZ (2003) Laser arytenoidectomy and vocal cord lateralization for bilateral abductor vocal cord paralysis. Pak J Otolaryngol 19:19–21

    Google Scholar 

  6. 6.

    Gupta AK, Mann SB, Nagarkar N (1997) Surgical management of bilateral immobile vocal folds and long term followup. J Laryngol Otol 111(5):474–477

    CAS  PubMed  Google Scholar 

  7. 7.

    Tucker HM (1976) Human laryngeal reinnervation. Laryngoscope 86:769–779

    CAS  PubMed  Article  Google Scholar 

  8. 8.

    Riffat F, Palme CE, Veivers D (2012) Endoscopic treatment of glottis stenosis: a report on the safety and efficacy of CO2 laser. J Laryngol Otol 126(5):503–505

    CAS  PubMed  Article  Google Scholar 

  9. 9.

    Pinto JA, Godoy LB, Marquis VW, Sonego TB, Leal Cde F (2011) Bilateral vocal fold immobility: diagnosis and treatment. Braz J Otorhinolaryngol 77(5):594–599

    PubMed  Google Scholar 

  10. 10.

    Bajaj Y, Sethi N, Shayah A, Harris AT, Henshaw P, Coatesworth AP, Nicolaides AR (2009) Vocal fold paralysis: role of bilateral transverse cordotomy. J Laryngol Otol 123(12):1348–1351

    CAS  PubMed  Article  Google Scholar 

  11. 11.

    Dennis DP, Kashima H (1989) Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 98(12 Pt 1):930–934

    CAS  PubMed  Article  Google Scholar 

  12. 12.

    Eckel HE, Thumfart M, Wassermann K, Vossing M, Thumfart WF (1994) Cordectomy versus arytenoidectomy in the management of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 103(11):852–857

    CAS  PubMed  Article  Google Scholar 

  13. 13.

    Remacle M, Lawson G, Mayne A, Jamart J (1996) Subtotal carbon dioxide laser arytenoidectomy by endoscopic approach for treatment of bilateral cord immobility in adduction. Ann Otol Rhinol Laryngol 105(6):438–445

    CAS  PubMed  Article  Google Scholar 

  14. 14.

    Ossoff RH, Sisson GA, Duncavage JA, Moselle HI, Andrews PE, McMillan WG (1984) Endoscopic laser arytenoidectomy for the treatment of bilateral vocal cord paralysis. Laryngoscope 94(10):1293–1297

    CAS  PubMed  Article  Google Scholar 

  15. 15.

    Benninger MS, Bhattacharyya N, Fried MP (1998) Surgical management of bilateral vocal fold paralysis. Oper Tech Otolaryngol 9(4):224–229

    Article  Google Scholar 

  16. 16.

    Bestall JC, Paul EA, Garrod R et al (1999) Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 54(7):581–586

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  17. 17.

    Stenton C (2008) The MRC breathlessness scale. Occup Med 58(3):226–227

    Article  Google Scholar 

  18. 18.

    Maurizi M, Paludetti G, Galli J, Cosenza A, Di Girolamo S, Ottaviani F (1999) CO2 laser subtotal arytenoidectomy and posterior true and false cordotomy in the treatment of post-thyroidectomy bilateral laryngeal fixation in adduction. Eur Arch Otorhinolaryngol 256(6):291–295

    CAS  PubMed  Article  Google Scholar 

  19. 19.

    Oswal VH, Gandhi SS (2009) Endoscopic laser management of bilateral abductor palsy. Indian J Otolaryngol Head Neck Surg 61(Suppl 1):47–51

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  20. 20.

    Werner JA, Lippert BM (2002) Lateral fixation of the vocal cord instead of tracheotomy in acute bilateral vocal cord paralysis. Dtsch Med Wochenschr 127(17):917–922

    CAS  PubMed  Article  Google Scholar 

  21. 21.

    Pérouse R, Coulombeau B, Arias C, Casanova C (2006) Lateral fixation of the vocal fold (Lichtenberger’s technique): interest in the bilateral laryngeal immobilities. Rev Laryngol Otol Rhinol 127(5):353–355

    Google Scholar 

  22. 22.

    Aderriotis D, Sàndor GK (1999) Outcomes of irradiated polyglactin 910 Vicryl Rapide fast-absorbing suture in oral and scalp wounds. J Can Dent Assoc 65(6):345–347

    CAS  PubMed  Google Scholar 

  23. 23.

    Kashima HK (1991) Bilateral vocal fold motion impairment: patho-physiology and management by transverse cordotomy. Ann Otol Rhinol Laryngol 100(9 Pt 1):717–721

    CAS  PubMed  Article  Google Scholar 

  24. 24.

    Mohamad I, Jihan WS, Mohamad H, Abdullah B (2008) Laser posterior cordotomy for bilateral abductor vocal cord palsy: a case report. Malays J Med Sci 15(1):42–43

    PubMed Central  PubMed  Google Scholar 

  25. 25.

    Harnisch W, Brosch S, Schmidt M, Hagen R (2008) Breathing and voice quality after surgical treatment for bilateral vocal cord paralysis. Arch Otolaryngol Head Neck Surg 134(3):278–284

    PubMed  Article  Google Scholar 

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Acknowledgments

All financial and material support by MCV Memorial ENT Trust Hospital.

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Correspondence to Veluswamy Anand.

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Anand, V., Kumaran, B.R. & Chenniappan, S. Cordoplasty: A New Technique for Managing Bilateral Vocal Cord Paralysis and Its Comparison with Posterior Cordotomy and External Procedure in a Large Study Group. Indian J Otolaryngol Head Neck Surg 67, 40–46 (2015). https://doi.org/10.1007/s12070-014-0740-4

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Keywords

  • Bilateral vocal cord paralysis
  • Laser surgery
  • Cordotomy
  • Voice quality