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

Abstract

clinicaltrials.gov Identifier: ISRCTN08093874.

A comparison of two endoscopic posterior cordotomy techniques: Laser cordotomy vs diathermy‐assisted cordotomy

“…1 However, they also evaluated their patients with Dyspnea Severity Scale, and the rate of dyspnoea improvement was reported significantly lower in laser-assisted cordotomy which was attributed to the low thermal damage of lasers. 15 High decannulation rates are also reported in many previous studies. [16][17][18] Pulmonary function tests allow the physician to assess and dis- The results of this study support that both laser and diathermyassisted posterior chordotomy significantly improve pulmonary function outcomes and also correlate with other previous reports.…”

“…Decannulation rate was 100% at the postoperative sixth month despite one postoperative tracheotomy in group 1 and two in group 2. Similarly, Mohammed et al reported 100% decannulation rates in their laser and diathermy‐assisted posterior chordotomy patients However, they also evaluated their patients with Dyspnea Severity Scale, and the rate of dyspnoea improvement was reported significantly lower in laser‐assisted cordotomy which was attributed to the low thermal damage of lasers . High decannulation rates are also reported in many previous studies …”

“…As the integrity of the vocal folds is disrupted, one can expect to have aspiration to a degree. Previous studies report that as long as the surgical procedure is limited to cordotomy, symptomatic aspiration is not expected . However, some authors reported aspiration in the case of arytenoidectomy.…”

“…Previous studies report that as long as the surgical procedure is limited to cordotomy, symptomatic aspiration is not expected. 11,15,19,20…”

Cordectomía posterior en el tratamiento de la parálisis bilateral de cuerdas vocales. ¿Debe ser la edad una limitación en su indicación?

“…Respetar la integridad de los aritenoides y de la comisura posterior así como de las estructuras supraglóticas disminuye la tasa de posibles complicaciones [21,22]. Otros dispositivos diferentes al láser CO 2 se han descrito para la realización de esta técni-ca [23,24]. Sin embargo, todas presentan un índice similar de éxito por lo que el uso del láser carbónico resulta en nuestro caso de elección debido a la amplia experiencia que se dispone en su uso en cirugía oncológica.…”