Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;23(4):65-70.
doi: 10.21315/mjms2016.23.4.9. Epub 2016 Jun 30.

A Ten-Year Kuala Lumpur Review on Laser Posterior Cordectomy for Bilateral Vocal Fold Immobility

Azman Mawaddah  1 , Mat Baki Marina  1 , Sawali Halimuddin  2 , Mohd Yunus Mohd Razif  1 , Sani Abdullah  1
Affiliations

A Ten-Year Kuala Lumpur Review on Laser Posterior Cordectomy for Bilateral Vocal Fold Immobility

Azman Mawaddah et al. Malays J Med Sci. 2016 Jul.

Abstract

Bilateral vocal fold immobility (BVFI) is commonly caused by injury to the recurrent laryngeal nerve (RLN) and leads to stridor and dyspnea of varying onsets. A retrospective study was done at the Department of Otorhinolaryngology of Universiti Kebangsaan Malaysia Medical Centre on laser microsurgical posterior cordectomy for BVFI. The objectives were to identify the average duration of onset of stridor from the time of insult and to evaluate the outcome of laser posterior cordectomy as a surgical option. From 1997 to 2007, a total of 31 patients with BVFI were referred for surgery. Twelve patients had tracheostomy done prior to the procedure, whereas 19 patients were without tracheostomy. Ten patients were successfully decannulated, and only 4 patients had complications related to the procedure. The minimum onset of stridor was 7 months, maximum onset of stridor was 28 years, and the mean onset of stridor was 8.7 years. The commonest complication observed was posterior glottic adhesion following bilateral posterior cordectomy. Laser endolaryngeal posterior cordectomy is an excellent surgical option as it enables successful decannulation or avoidance of tracheostomy in patients with BVFI. The onset of stridor took years after the insult to the recurrent laryngeal nerves.

Keywords: pulsed laser tissue ablation; recurrent laryngeal nerve; stridor; thyroidectomy; vocal cord paralysis.

PubMed Disclaimer

Figures

Figure 1(a)
Figure 1(a)
A horizontal incision is performed at the posterior third of the vocal cord
Figure 1(b)
Figure 1(b)
A triangular shaped area posterior to the incision was ablated
Figure 1(c)
Figure 1(c)
Endoscopic view of the larynx intraoperatively showing the resultant airway created
See this image and copyright information in PMC

References

    1. Kashima H. Bilateral vocal fold motion impairment: Pathophysiology and management by transverse cordotomy. Annals of Otology, Rhinology & Laryngology. 1991;100(9):717–721. http://dx.doi.org/10.1177/000348949110000905. - DOI - PubMed
    1. Yin SS, Qiu WW, Stacker FJ, Hoasjoe DK, Aarstad RF. Evaluation of bilateral vocal fold dysfunction: paralysis versus fixation, superior versus recurrent, and distal versus proximal to the laryngeal nerves. Laryngoscope. 1984;94:954–958. - PubMed
    1. Woodson G. Evolving concepts of laryngeal paralysis. JLaryngol Otol. 2007;122(5) - PubMed
    1. Hollinger LD, Hollinger PC, Hollinger PH. Etiology of bilateral abductor vocal cord paralysis: A review of 389 cases. Ann Otol Rhinol Laryngol. 1976;85:428–436. http://dx.doi.org/10.1177/000348947608500402. - DOI - PubMed
    1. Feehery J, Pribitkin E, Heffelfinger R, Lacombe V, Lee D, Lowry L, et al. The evolving etiology of bilateral vocal fold immobility. Journal of Voice. 2003;17(1):76–81. - PubMed

LinkOut - more resources