Among these, transoral CO 2 laser posterior cordotomy is one of the most popular surgical techniques, due to the low rates of complications, absence of external scar, and short surgical and hospitalization times. Nowadays, a wide spectrum of surgical procedures by transoral or open-neck approaches are available. The ideal surgical option should ensure a better quality of life by relieving airway obstruction and preserving laryngeal functions such as phonation and deglutition. Until the 1920s, tracheotomy was the only treatment routinely applied, while at present, its application is mainly limited to emergency situations to provide immediate respiratory relief. However, to date, in the medical community general agreement on the surgical treatment that will grant patients the best quality of life is still lacking. Patients often show severe dyspnea or stridor with no obvious voice disorders. The clinical profile of the patient affected by BAVCP is quite variable: at onset, a patient may complain of a breathy voice without respiratory fatigue progressively, vocal performance may even improve, while respiratory symptoms worsen. The most frequent etiology of BAVCP is iatrogenic trauma (44%), and the majority are related to thyroid surgery other reported causes are malignancies (17%), endotracheal intubation (15%), neurologic diseases (12%), and idiopathic (12%). BAVCP is the most common neurological disorder of the larynx and may result from vagal or recurrent laryngeal nerve damage or from a central lesion. Conclusionsįor patients affected by BAVCP, PC ± MPA by transoral CO 2 laser microsurgery is a safe, customizable and minimally invasive treatment that can guarantee an affordable balance between quality of life in terms of phonation and swallowing and acceptable airway patency.īilateral adductor vocal cord paralysis (BAVCP) is an uncommon but challenging problem for the head and neck surgeon. All nine patients with a tracheostomy were successfully decannulated within 18 months after the surgical procedure. A significant improvement in responses for the ADVS ( p < .0001) and EAT-10 ( p < .0001) was observed, whereas the VHI-30 score did not change significantly post-operatively. In 22 cases (66.7%), PC was combined with MPA. The etiology was post-surgical in 27 cases (81.8%), idiopathic in 4 (12.1%), a trauma-related in 1 (6.0%), and to other causes in 1 (3.0%). Thirty-three patients met selection criteria. Secondary outcomes were the need for retreatments and, for patients with tracheotomy, the time to decannulation. The primary outcome was change in quality of life, evaluated pre- and post-operatively by the ADVS, VHI-30, and EAT-10 questionnaires. We retrospectively evaluated patients affected by BAVCP and treated by transoral CO 2 posterior cordotomy with or without medial partial arytenoidectomy (PC ± MPA) at two referral centers.

We investigated the effect of transoral glottal widening on quality of life and decannulation rates in patients affected by BAVCP. Bilateral adductor vocal cord paralysis (BAVCP) is a rare and challenging condition whose main consequence is reduction of airway patency at the glottic level, often causing respiratory distress, while vocal function tends to remain almost normal.

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