Posterior cordotomy for bilateral paralysis of the vocal cord

OBJECTIVE To evaluate the efficacy of posterior cordotomy for patients with bilateral paralysis of the vocal cord.METHODS Five patients with bilateral paralysis of the vocal cord underwent CO2 laser assisted posterior cordotomy for decannulation in our hospital from Jan.2009 to June.2010.Unilateral posterior cordotomy was performed in 3 cases and bilateral posterior cordotomy in 2 cases.There were one male and four female patients with their age ranged from 30 to 68 years.The causes of the bilateral paralysis of the vocal cord were total thyroidectomy in 4 cases and cervical trauma in one case.Three cases were previously tracheotomized before hospitalization and other two patients underwent tracheotomy before posterior cordotomy due to severe dyspnea.RESULTS Complications were not encountered in the CO2 laser assisted posterior cordotomy.The tracheotomy tube was plugged next day after posterior cordotomy.All of the five patients were breathing well without any effort.One patient was decannulated 8 days after operation,other 4 cases were reexamined 3 months later.The laryngoscopy showed enough glottis for breathing.Three cases were decannulated.One patient was not decannulated because lung metastasis of thyroid cancer,even she was breathing without any effort for plugged tracheotomy tube.All the patients satisfied with their voice and no evidence of clinical aspiration occurred.CONCLUSION Our limited experience showed that CO2 laser assisted posterior cordotomy is an effective and reliable surgical procedure for patients with bilateral paralysis of the vocal cord.