Laser Versus Diathermy Assisted Posterior Cordotomy In Treatment Of Bilateral Abductor Palsy Vocal Cord

Bilateral vocal cord immobility is rare but a challenging complication. Iatrogenic injury to bilateral recurrent laryngeal nerves during thyroid surgery is the commonest cause (Benninger et al.; 1998), (Manolopoulos et al.; 1999). As both the vocal cords are usually in paramedian position, patient has little problem with voice but airway sooner or later will be compromised (Watkinson et al.; 2000).The aim of this study was to compare results of laser assisted posterior cordotomy to diathermy assisted posterior cordotomy as procedures for bilateral abductor vocal cords paralysis treatment in regard to improvement of airway, quality of voice and laryngeal sphincter mechanism.In study 20 patients (4 male & 16 female) were included who were diagnosed with bilateral vocal cords abductor paralysis mostly after thyroidectomy surgery. The age of these patients ranged between 30 to 70 years. 10 patients were subjected to treatment with laser assisted posterior cordotomy [Group (A)] and 10 patients were subjected to treatment with diathermy assisted posterior cordotomy [Group (B)]. All these patients were followed up for one year .Initially at one weak interval for one months and then at monthly interval for next one year.Results of pre-operative comparison between group (A) & group (B) in dyspnea category revealed non significance difference.Results of post-operative comparison between group (A) & group (B) in dyspnea category revealed a significant difference at all postoperative periods in favor of laser surgery being less followed by dyspnea.Results of post-operative comparison between group (A) & group (B) in Voice quality revealed non significance difference at all postoperative periods.None of the patients subjected to laser or diathermy assisted posterior cordotomy had aspiration in the postoperative period or during follow-up.