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Impact of unilateral carbon dioxide laser posterior transverse cordotomy on vocal and aerodynamic parameters in bilateral vocal fold paralysis

Published online by Cambridge University Press:  18 March 2016

M B Asik ,
O Karasimav ,
H Birkent ,
A L Merati ,
M Gerek  and
Y Yildiz
M B Asik*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
O Karasimav
Affiliation:
Department of Sports Medicine, Gulhane Military Medical Academy, Ankara, Turkey
H Birkent
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
A L Merati
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Washington, Seattle, USA
M Gerek
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
Y Yildiz
Affiliation:
Department of Sports Medicine, Gulhane Military Medical Academy, Ankara, Turkey
*
Address for correspondence: Dr M Burak Asik, Gulhane Askeri Tip Akademisi, KBB AD, 06018 Etlik, Ankara, Turkey E-mail: burock312@yahoo.com
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Abstract

Objectives:

Carbon dioxide laser posterior transverse cordotomy is a common option for bilateral vocal fold paralysis. This study prospectively evaluated aerodynamic and acoustic effects of unilateral carbon dioxide laser posterior transverse cordotomy in bilateral vocal fold paralysis patients.

Methods:

The study comprised 11 bilateral vocal fold paralysis patients (9 females, 2 males), with a mean age of 46.6 ± 14.1 years. All patients were treated by laser posterior transverse cordotomy. Pre-operative and two-month post-operative assessments were conducted, including: dyspnoea scales, maximum phonation time measurement, spirometry and bicycle ergometry.

Results:

All subjective and objective aerodynamic parameters showed statistically significant improvements between the pre- and post-operative period. Objective spirometric and ergometric parameters showed a significant increase post-operatively. The changes in objective voice parameters (fundamental frequency (f0), jitter, shimmer, soft phonation index and noise-to-harmonic ratio) were statistically non-significant; however, there was a significant improvement in subjective voice parameters post-operatively, as assessed by the voice handicap index and grade-roughness-breathiness-asthenia-strain scale (p = 0.026 and p = 0.018 respectively).

Conclusion:

Unilateral carbon dioxide laser posterior transverse cordotomy is an effective procedure that results in improved dyspnoea and aerodynamic performance with some worsening of voice parameters.

Keywords

Vocal Cord ParalysisCordotomyRespirationVoiceSpirometry
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 4 , April 2016 , pp. 373 - 379
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented orally at the Fall Voice Conference, 23–25 October 2014, San Antonio, Texas, USA.

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