Endoscopic laser cordotomy for bilateral recurrent paralysis – comments on a clinical case

Abstract

Introduction. Bilateral recurrent paralysis treatment has changed in the last decades as various procedures have been developed in order to superiorly preserve the functions of the larynx. For life-threatening situations tracheotomy remains the treatment of choice. Case presentation. In this article we present the case of a 64 year-old patient, known with bilateral recurrent paralysis, who presented to our clinic with mild to moderate inspiratory dyspnea on effort. The endoscopic examination revealed the vocal folds in paramedian position, with a respiratory space reduced by 80%. We performed an endoscopic posterior cordotomy, also known as Kashima procedure. Conclusions. Kashima procedure or endoscopic laser posterior cordotomy is a preferred technique with better long term outcomes. It prevents the necessity of tracheotomy and improves the quality of life of the patient, by both widening the airway and preserving phonation.

Keywords

• bilateral recurrent paralysis
• laser cordotomy