Monopolar microelectrodes versus radiofrequency in posterior cordotomy for bilateral vocal fold paralysis

Abstract

Background Bilateral abductor vocal fold paralysis (BAVFP) is an uncommon condition with potentially significant negative effects on breathing and quality of life. It presents as one of the most difficult problems for the laryngologist. Located at the crossroads of the airway and food passages, the larynx provides three important functions: airway protection, respiration, and phonation, which are affected by paralysis of one or both vocal folds. Aims The aims of treatment of BAVFP are to provide adequate airway, preservation of voice quality, and laryngeal competence. Patients and methods This is a randomized, prospective clinical trial that was carried out on 20 patients with BAVFP, who were subjected to endoscopic/assisted microscopic posterior cordotomy at the Department of Otorhinolaryngology, Tanta University Hospital. The study was carried out from first February 2019 till April 2020. The patients were allocated into two groups: group A patients were operated with radiofrequency. Group B patients were operated with monopolar microelectrodes. Grade of dyspnea, exercise tolerance test, voice handicap index-10, MD Anderson Dysphagia Inventory, and aspiration were evaluated preoperatively and 2 weeks and 3 months postoperatively. Results Both techniques were successful in postoperative glottic chink, exercise tolerance, dyspnea, and aspiration. There was a significant difference (P=0.007) between group A and group B at 3 months postoperative voice handicap index-10. Conclusion Both techniques could be used as an easy and cheap alternative in performing posterior transverse cordotomy.