Clinical Medicine Insights: Ear, Nose and Throat

BACKGROUND: Bilateral abductor vocal fold paralysis can lead to respiratory distress and dyspnea.

OBJECTIVES: To assess the efficacy of CO₂ laser unilateral posterior cordotomy in cases with bilateral abductor paralysis as regards improvement of dyspnea with preservation of satisfactory voice and swallowing after the operation.

METHODS: A prospective study was done on 18 patients with bilateral abductor vocal fold paralysis (10 females and 8 males) from November 2010 to December 2012 with their ages ranging from 32 to 64 years.

RESULTS: All patients showed improvement of dyspnea after the operation, most of the patients suffered from mild to moderate dyspnea in the immediate post-operative period, and two patients needed another intervention to solve it. All the patients had satisfactory results of their voice after the operation, and one patient only suffered from temporary aspiration.

CONCLUSION: Unilateral CO₂ laser posterior cordotomy is an easy and effective procedure to solve the dyspnea after bilateral vocal fold abductor paralysis without aspiration or significant voice alteration.