Plastic cordotomy in the treatment of bilateral vocal fold immobility

Abstract

Background: The purpose of this study was to evaluate a new surgical method, plastic cordotomy for treatment of bilateral vocal fold immobility.

Methods: We used cadaver experiments on 20 larynges to measure the widening of the glottis after bilateral plastic cordotomy. We conducted a prospective study of 21 female patients operated on with bilateral plastic cordotomy.

Results: Bilateral plastic cordotomy enlarged the width of glottis to 9.55 (range, 8.3-10) mm in men and 8.5 (range, 7.4-8.8) mm in women and the area of glottis to 110.5 mm(2) (range, 88-149 mm(2) ) in men and to 84.5 mm(2) (range, 59-107 mm(2) ) in women. Clinical study revealed that the mean of peak inspiratory flow increased from 1.09 (0.41) L/seconds before surgery to 2.85 (0.67) L/seconds in long-term.

Conclusion: Plastic cordotomy is an effective, anatomically based method to alleviate obstruction in bilateral vocal fold immobility patients. The main advantage of plastic cordotomy is long-term stability of results due to prevention of restenosis.