Surgical management of bilateral abductor vocal cord paralysis using Coblation technology

Abstract

Objective: Management of bilateral abductor paralysis of vocal folds often poses a surgical challenge. Among various surgical modalities, surgical transaction/excision of posterior aspect of the vocal folds is an established modality. The objective of the present study is to evaluate the effectiveness and safety of the technique using Coblation technology. Study Design: This was a retrospective review. Setting: This study was conducted in a tertiary health care center. Materials and Methods: Fourteen consecutive patients meeting inclusion criterion undergoing posterior cordectomy using Coblator were included in this study. Preoperative subjective voice analysis was done and compared with measurements at 6 months postprocedure. Parameters studied included voice handicap index (VHI), the need for repeat procedures, effect of decannulation, and subjective improvement in respiratory distress. Results: There was a significant improvement in the airway as adjudged by the postoperative subjective improvement in respiratory distress (in 2 nontracheostomized patients) and uneventful decannulation (in 12 tracheostomized patients). However, the postoperative VHI scores showed no statistically significant difference with the preoperative assessment. One of the patients required the procedure to be repeated owing to recurrence of respiratory distress. No untoward incident was reported in any of the surgical procedures. Conclusion: Posterior cordectomy using a Coblator offers a safe and efficacious option for the management of compromised airway secondary to bilateral abductor paralysis of vocal folds. It offers a significant airway improvement without any significant effect on voice.