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

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Abstract

IMPORTANCE

A reliable procedure is needed to solve the problem of difficult airway in patients with bilateral vocal cord paralysis without adversely affecting patient “voice quality.”

OBJECTIVES

To compare the results of laser-assisted posterior cordotomy with diathermy-assisted posterior cordotomy for bilateral vocal cord paralysis in regard to dyspnea severity, voice quality, and aspiration.

DESIGN

Prospective randomized clinical trial at a university medical center.

SETTING

Zagazig University Hospitals, Zagazig, Egypt.

PARTICIPANTS

Twenty patients randomly categorized into 2 groups; group A was treated with laser-assisted posterior cordotomy and group B was treated with diathermy-assisted posterior cordotomy.

INTERVENTION

Laser-assisted posterior cordotomy for group A and diathermy-assisted posterior cordotomy for group B.

MAIN OUTCOME AND MEASURE

Dyspnea severity, voice quality, and aspiration.

RESULTS

A significant difference (P < .05) was found between group A and group B at all postoperative comparisons in dyspnea, whereas no significant difference (P ≥ .05) was detected at all postoperative comparisons in voice quality.

CONCLUSIONS AND RELEVANCE

Laser-assisted posterior cordotomy can be considered as a reliable and superior procedure compared with diathermy-assisted posterior cordotomy in the treatment of bilateral vocal cord abductor paralysis.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: ISRCTN08093874

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