• Arno Olthoff, Daniel Zeiss, Rainer Laskawi, Eberhard Kruse, and Wolfgang Steiner.
• Dept of Phoniatrics and Pedaudiology, University of Göttingen, Robert-Koch-Str 40, D-37075 Göttingen, Germany.
• Ann Oto Rhinol Laryn. 2005 Aug 1;114(8):599-604.

ObjectivesWe performed a prospective study to assess respiratory function and voice quality before and after laser microsurgical bilateral posterior cordectomy performed for chronic airway obstruction in patients with bilateral vocal fold paralysis.MethodsIn 17 patients a laser microsurgical posterior cordectomy was performed as an immediate bilateral approach. Roughness, breathiness, hoarseness, and dyspnea were evaluated both subjectively (on a scale from 0 to 3) and objectively (body plethysmography, computerized voice analysis: Göttingen Hoarseness Diagram).ResultsAfter laser surgery, the patients' respiratory function was significantly increased and was sufficient for all activities of daily living. The body plethysmographic measure of airway resistance had superior descriptive power and correlated significantly with the clinical degree of dyspnea (scale 0 to 3). Pretreatment and posttreatment impairment of voice quality was objectively documented with the Göttingen Hoarseness Diagram; the phonatory results measured with it correlated significantly with the subjective clinical evaluation of hoarseness. Aphonia did not occur.ConclusionsA bilateral approach for laser microsurgical posterior cordectomy combines excellent airway improvement and satisfactory voice preservation. In bilateral vocal fold paralysis, pretreatment and posttreatment clinical data should be evaluated by objective measures.

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