title: Impact of unilateral carbon dioxide laser posterior transverse cordotomy on vocal and aerodynamic parameters in bilateral vocal fold paralysis.
abstract: OBJECTIVE
  Carbon dioxide laser posterior transverse cordotomy is a common option for bilateral vocal fold paralysis. This study prospectively evaluated aerodynamic and acoustic effects of unilateral carbon dioxide laser posterior transverse cordotomy in bilateral vocal fold paralysis patients.
  
  
  METHODS
  The study comprised 11 bilateral vocal fold paralysis patients (9 females, 2 males), with a mean age of 46.6 ± 14.1 years. All patients were treated by laser posterior transverse cordotomy. Pre-operative and two-month post-operative assessments were conducted, including: dyspnoea scales, maximum phonation time measurement, spirometry and bicycle ergometry.
  
  
  RESULTS
  All subjective and objective aerodynamic parameters showed statistically significant improvements between the pre- and post-operative period. Objective spirometric and ergometric parameters showed a significant increase post-operatively. The changes in objective voice parameters (fundamental frequency (f0), jitter, shimmer, soft phonation index and noise-to-harmonic ratio) were statistically non-significant; however, there was a significant improvement in subjective voice parameters post-operatively, as assessed by the voice handicap index and grade-roughness-breathiness-asthenia-strain scale (p = 0.026 and p = 0.018 respectively).
  
  
  CONCLUSIONS
  Unilateral carbon dioxide laser posterior transverse cordotomy is an effective procedure that results in improved dyspnoea and aerodynamic performance with some worsening of voice parameters.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Gulhane Military Medical Academy,Ankara,Turkey.
authors.forename: M B
authors.initials: MB
authors.lastname: Asik
authors.affiliation: Department of Sports Medicine,Gulhane Military Medical Academy,Ankara,Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Karasimav
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Gulhane Military Medical Academy,Ankara,Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Birkent
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,University of Washington,Seattle,USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Merati
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Gulhane Military Medical Academy,Ankara,Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Gerek
authors.affiliation: Department of Sports Medicine,Gulhane Military Medical Academy,Ankara,Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Yildiz
mesh_terms: D000328:Adult; D002818:Cordotomy / Q000379:methods*; D004417:Dyspnea / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010699:Phonation; D011184:Postoperative Period; D011446:Prospective Studies; D013147:Spirometry; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014827:Vocal Cords / Q000601:surgery*; D014833:Voice Quality
keywords: Cordotomy; Respiration; Spirometry; Vocal Cord Paralysis; Voice