What is the role of transverse laser cordotomy in the treatment of cricoarytenoid (CA) fixation?

Updated: Jul 27, 2021
  • Author: Paul C Bryson, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

The transverse laser cordotomy, which Kashima (1991) popularized, is designed to enlarge the posterior glottic airway while maintaining close opposition of the anterior true vocal folds for phonation. [14] A radial incision is made in the membranous vocal fold immediately anterior to the vocal process of the arytenoid. The resulting wedge-shaped defect in the posterior glottis is due to the anterior retraction of the thyroarytenoid muscle. In cricoarytenoid (CA) fixation, the magnitude of posterior glottic enlargement with cordotomy is entirely independent of arytenoid position and mobility, unlike with the techniques designed to achieve vocal-fold lateralization. The technical ease and minimal tissue destruction in this procedure are additional advantages. Cutting techniques other than the CO2 laser were more recently proposed to affect the same posterior cordotomy surgical defect.


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