gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNOKHC)

ISSN 1865-1038

Posterior cordomtomy for bilateral vocal cord paralysis: CO2 laser vs. microsurgery with cold instruments


  • corresponding author Stelian Lupescu - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien
  • Alin H. Marin - Univ. Victor Babes, Dept. ENT, Timisoara, Rumanien
  • V. Draganescu - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien
  • Nicolae Balica - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien
  • Stan Cotulbea - Univ. Victor Babes, Dept. ENT, Timisoara, Rumänien

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2012;8:Doc21

doi: 10.3205/cpo000674, urn:nbn:de:0183-cpo0006741

Published: April 19, 2012

© 2012 Lupescu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Idea: The restoration of the airways after bilateral vocal cord paralysis is still a challenge for the otolaryngologist. Techniques including endoscopic approaches (Kashima's technique) have been developed for management of adduction bilateral vocal cord paralysis.

Method: From 1998 to 2011, 20 patients were endoscopically treated by CO2 Laser (15 patients) and by cold microsurgical instruments (5 patients) in our ENT Department. A better and simpler procedure is cordotomy using the Kashima technique. This involves separating one vocal cord from the vocal process, creating a posterior gap for respiration and maintaining anterior vocal cord contact for phonation.

Results: The aetiology of vocal cord paralysis of our patients was the following: posttyroidectomy (8), central nervous system disease (7), idiopathic (5). All treatments were performed in one stage, except for one patient who underwent three month after operation a contralateral cordotomy. Post-operative assessment was performed and consisted of videolaryngoscopy with 70 degree rigid endoscope. The respiratory function and the phonation presented the similar results in both techniques. The healing process was delayed in cases of microsurgery with cold instruments. Speech therapy is used to supplement the operation.

Conclusion: Our experience suggests that bilateral vocal cord paralysis can be primarily treated by posterior cordotomy. Moreover, the different therapeutic choices should be adjusted by the surgeon for the patient's gender, age, general conditions, physical and professional activities.