Plastic cordotomy in the treatment of bilateral vocal fold immobility.

Abstract

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