Surgical management of laryngeal bilateral abductor palsy: comparative study between carbon dioxide and diode lasers

Abstract

This study aims to compare the results of both CO₂ laser and diode laser combined arytenoidectomy with posterior cordectomy in managing patients with bilateral vocal fold paralysis. A prospective study involved 80 bilateral vocal cord immobility patients in adduction. They are divided into two groups according to the laser used, whether CO₂ (with a wavelength of 10.6 µm) or diode (with a wavelength of 980 nm). We used mMRC (Modified Medical Research Council) dyspnea scale to assess dyspnea in our patients, while the voice was evaluated by both maximum phonation time and the voice handicap index. Quantitative variables were described using means and standard deviations, while categorical variables were described using frequencies and were compared using the chi-square test, Fisher exact test, and Monte Carlo test. There was a statistically non-significant difference between the studied groups regarding mMRC dyspnea scale and Voice Handicap Index preoperatively and postoperatively. There is a statistically significant difference between the two groups regarding maximum phonation time postoperatively (significantly higher in the CO₂ laser group) (p < 0.001). The CO₂ laser and diode laser could be used safely for the management of bilateral vocal cord paralysis. The CO₂ laser maintains better voice parameters and less postoperative pain, while the diode laser gives less operative time, lower cost, and simplicity of use.

Keywords: Bilateral vocal fold paralysis; CO2 laser; Diode laser; Glottis.

Fig. 1

Diagrammatic summary presentation of our patients