Original Article TREATMENT OF IATROGENIC BILATERAL ADDUCTOR VOCAL CORD IMMOBILITY BY ENDOSCOPIC POSTERIOR TRANSVERSE CORDOTOMY

Objectives: To access the efficacy, safety and complication rate of posterior transverse cordotomy with electrocautry in the treatment of iatrogenic bilateral vocal cord immobility. Methodology: This prospective quasi-experimental study included 12 female patients with iatrogenic bilateral vocal cord immobility after thyroid surgery, which came to outpatient clinic of department of otolaryngology of a tertiary care teaching hospital in Rawalpindi, between January 2004 to December 2007. In all patients, endoscopic posterior transverse cordotomy was done with electrocautry under general anesthesia. These patients were followed up for six months and accessed for decannulation rate, postoperative voice and complications. Results: Nine out of 12 patients (75%) had successful decannulation on 3rd postoperative day. Only two (16.6%) required revision surgery on opposite vocal cord and were decannulated making overall decannulation rate of 91.6%. Postoperative voice analysis showed that eight patients (66.6%) had ‘better ’ voice, three (25%) had ‘same ’ whereas only one patient (8.3%) had ‘worse’ voice. Postoperatively, six patients (50%) had no dyspnoea, five (41.6%) had mild and one (8.3%) patient had severe dyspnoea. None of the patients had aspiration or swallowing difficulty. The whole procedure took 8 to 19 minutes with mean duration of 10.6 minutes. Conclusions: Treatment of iatrogenic bilateral vocal cord immobility with electrocautry can produce adequate postoperative airway and voice. This procedure is safe and not associated with any significant complications