Comparison between laser- and diathermy-assisted posterior cordotomy for bilateral vocal cord abductor paralysis.

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.