CO2 laser posterior ventriculocordectomy for the treatment of bilateral vocal cord paralysis

We reviewed our clinical experience between 1991 and 1997 concerning use of the CO2 laser for posterior ventriculocordectomy (PVC) for the treatment of bilateral vocal cord paralysis. Pre- and postoperative functional evaluation was assessed in a prospective setting. In all, 41 patients (33 females and 8 males) underwent an endoscopic CO2 laser PVC. Pre- and postoperative pulmonary function tests documented a significant statistical improvement in the parameters considered. Sixteen of 21 previously tracheostomized patients were decannulated within 15 months of operation. In no case was a postoperative tracheostomy required. We found no evidence of subclinical aspiration among our cases. Evaluation of vocal parameters by spectrographic analysis was assessed in 20 patients and revealed a postoperative reduction in voice quality. Laser CO2 PVC seems to be an effective and reliable surgical procedure that allows for rapid decannulation and gives stable results with a low incidence of revision surgery and functional failures.