Pediatric bilateral vocal fold immobility: The role of carbon dioxide laser posterior transverse partial cordectomy

Vocal fold paralysis in children has been estimated to be the second most c ommon congenital abnormality of the pediatric airway. Most commonly, childr en present with the vocal folds in the midline or adducted position. Pediat ric patients usually have a good voice or cry and a poor airway. In these c ases, the surgical goal will be improving the airway, usually by lateralizi ng a vocal fold, while maintaining a normal voice and intact swallowing. Th e focus of this article is a modification of a technique for use in adults that was introduced by Dennis and Kashima in 1989. The procedure is intende d to separate the vocal ligament and vocalis muscle from the arytenoid cart ilage with removal of significant tissue mass with the CO2 laser. The demog raphics and results of 5 pediatric patients who underwent this procedure ar e discussed. The preoperative goals of airway enlargement, voice preservati on, and normal deglutition were achieved in all 5 patients.