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Kashima's Posterior cordectomy using coablator our experience

Aim: To study the effectiveness of coblation technology in performing Kashima's procedure for bilateral abductor vocal fold paralysis. Methodology: Managing patients with bilateral vocal fold abductor paralysis is rather tricky one. It calls for delicate balance between airway and phonation. Various endolaryngeal techniques have been used to manage this problem. Here the authors describe their experience with posterior cordectomy using coablator. This study includes 10 patients who presented with stridor following bilateral abductor paralysis. All our patients were on tracheostomy tubes. They were very anxious with the tube and wanted decannulation done. All of these patients were operated by the same senior surgeon. These patients were managed with posterior cordotomy using coablation. Laryngeal wands were used in all these patients. These patients underwent spiggoting of their tracheostomy tube on the first post operative day. Decannulation was completed on the third post operative day. Early decannulation was made possible because there was negligible soft tissue oedema as these patients underwent coblation procedure.

Observation: On discharge all of them had a good voice and adequate airway. These patients were able to climb two flights of stairs without discomfort.Although the causes of bilateral abductor paralysis of vocal cords are multifactorial post traumatic paralysis formed a large majority of our patients ( 8 who developed bilateral vocal fold paralysis following total thyroidectomy).

Author(s): Balasubramanian Thiagarajan Vrinda Balakrishnan Nair