Comparison of two endoscopic posterior partial transverse cordotomy techniques on bilateral vocal cold paralysis: Laser- and coblation-assisted cordotomy

Abstract

PurposeTo compare the effects of two treatment modalities, transoral endoscopic posterior partial transverse cordotomy (EPPTC) using CO2 laser and coblation on patients with bilateral vocal cold paralysis (BVCP). MethodsThis is a retrospective cohort study. Patients diagnosed with BVCP by electronic laryngoscope between 2009 and 2021 at the Department of Otolaryngology Head and Neck surgery of Sixth Medical Center in PLA General Hospital were included. All patients were treated with either coblation- or CO2 laser-assisted EPPTC. The relief of dyspnoea and reasonable vocal quality postoperatively has evaluated and compared. The decannulation rate and the restoration of the airway were compared. The complications after the surgery have also been recorded. ResultsFifty-five patients with BVCP underwent EPPTC were included. Among 55 patients, 38 patients were treated with CO2 laser-assisted EPPTC (laser group), while other 17 patients were treated with coblation-assisted EPPTC (coblation group). The operation time of coblation group was shorter compared with laser group (P < 0.05). There were no significant differences of the one-step successful decannulation rate (88.57% vs. 82.35%), two-step successful decannulation rate (91.43%% vs. 88.24%), one-step successful restoration of the airway rate (89.47% vs.82.35%) and two-step restoration of the airway rate (92.11% vs. 88.24%) between the two groups (P > 0.05). There were also no significant differences of the complications between the two groups (P > 0.05). ConclusionsThe efficiency and safety of the laser- and coblation-assisted EPPTC were similar. The coblation-assisted EPPTC was easier to operate and the operation time was shorter, which might be more suitable for patients with poor physical condition.